Provider Demographics
NPI:1225893886
Name:R & R HEALTH CARE ASSOCIATION, LLC
Entity Type:Organization
Organization Name:R & R HEALTH CARE ASSOCIATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:OSMANI
Authorized Official - Middle Name:
Authorized Official - Last Name:RICO VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:239-688-0033
Mailing Address - Street 1:1154 LEE BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-4852
Mailing Address - Country:US
Mailing Address - Phone:239-688-0033
Mailing Address - Fax:239-688-0024
Practice Address - Street 1:1154 LEE BLVD STE 4
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-4852
Practice Address - Country:US
Practice Address - Phone:239-688-0033
Practice Address - Fax:239-688-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL117510500Medicaid