Provider Demographics
NPI:1427591684
Name:ARTHRITIS AND RHEUMATOLOGY ASSOCIATES OF TREASURE COAST LLC
Entity Type:Organization
Organization Name:ARTHRITIS AND RHEUMATOLOGY ASSOCIATES OF TREASURE COAST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANJU
Authorized Official - Middle Name:B
Authorized Official - Last Name:WADHWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-800-7758
Mailing Address - Street 1:1701 SE HILLMOOR DR
Mailing Address - Street 2:D-16
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7552
Mailing Address - Country:US
Mailing Address - Phone:772-800-7758
Mailing Address - Fax:
Practice Address - Street 1:1701 SE HILLMOOR DR
Practice Address - Street 2:SUITE D-16
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7552
Practice Address - Country:US
Practice Address - Phone:772-800-7758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63650207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty