Provider Demographics
NPI:1104850437
Name:R&N PROFESSIONAL SERVICES, CORP
Entity Type:Organization
Organization Name:R&N PROFESSIONAL SERVICES, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-871-0550
Mailing Address - Street 1:1200 NW 78TH AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1891
Mailing Address - Country:US
Mailing Address - Phone:305-871-0550
Mailing Address - Fax:305-871-0551
Practice Address - Street 1:1200 NW 78TH AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1891
Practice Address - Country:US
Practice Address - Phone:305-871-0550
Practice Address - Fax:305-871-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651154600Medicaid
FL651154600Medicaid