Provider Demographics
NPI:1275132631
Name:RIVIERA BEACH INTEGRATED CARE INC
Entity Type:Organization
Organization Name:RIVIERA BEACH INTEGRATED CARE INC
Other - Org Name:RIVIERA BEACH INTEGRATED PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:561-510-0471
Mailing Address - Street 1:31 W 20TH ST
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-6155
Mailing Address - Country:US
Mailing Address - Phone:561-510-0471
Mailing Address - Fax:561-331-2715
Practice Address - Street 1:31 W 20TH ST
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-6155
Practice Address - Country:US
Practice Address - Phone:561-510-0471
Practice Address - Fax:561-331-2715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-18
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy