MEDICARE: REAL MEDCARE 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	363L00000X	Nurse Practitioner
2	363LG0600X	Gerontology Nurse Practitioner

General Provider Information

NPI Number	:	1962977553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REAL MEDCARE LLC

Provider Business Mailing Address
First Line	:	3935 BANKS LANDING CT
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441-4553
Country	:	US
Telephone Number	:	954-665-7258
Fax Number	:

Provider Business Practice Location Address
First Line	:	3935 BANKS LANDING CT
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441-4553
Country	:	US
Telephone Number	:	954-665-7258
Fax Number	:

Authorized Official
Title or Position	:	NP
Name	:	MARTIZA ROMERO
Credential	:
Telephone Number	:	954-665-7258

Provider Enumeration Date	:	10/10/2018
Last Update Date	:	04/16/2024

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