MEDICARE: ROYALTY MEDICAL CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP9298531	OTHER	FL	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811617160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYALTY MEDICAL CARE, LLC

Provider Business Mailing Address
First Line	:	108 STIRRUP LN
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-8289
Country	:	US
Telephone Number	:	561-310-8399
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 STIRRUP LN
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-8289
Country	:	US
Telephone Number	:	561-310-8399
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TERRYAN S DOUGLAS
Credential	:
Telephone Number	:	561-310-8399

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	08/29/2022

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