Provider Demographics
NPI:1467926022
Name:RESPIRATORY CARE PROVIDERS, INCORPORATED
Entity Type:Organization
Organization Name:RESPIRATORY CARE PROVIDERS, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCAVELLA
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:772-226-5059
Mailing Address - Street 1:5575 NW WESLEY CT
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-4232
Mailing Address - Country:US
Mailing Address - Phone:772-226-5059
Mailing Address - Fax:
Practice Address - Street 1:2401 FRIST BLVD STE 9
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4844
Practice Address - Country:US
Practice Address - Phone:772-919-4755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESPIRATORY CARE PROVIDERS, INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL60081050Medicaid