Provider Demographics
NPI:1467729095
Name:R MEDICAL, LLC
Entity Type:Organization
Organization Name:R MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-493-8875
Mailing Address - Street 1:2040 NE 49TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4524
Mailing Address - Country:US
Mailing Address - Phone:954-493-8875
Mailing Address - Fax:954-493-8876
Practice Address - Street 1:1008 W HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5243
Practice Address - Country:US
Practice Address - Phone:954-457-0155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL111N00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty