Provider Demographics
NPI:1508985003
Name:RMA MSO
Entity Type:Organization
Organization Name:RMA MSO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-318-6590
Mailing Address - Street 1:7800 W OAKLAND PARK BLVD STE E-214
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6741
Mailing Address - Country:US
Mailing Address - Phone:954-318-6590
Mailing Address - Fax:
Practice Address - Street 1:7800 W OAKLAND PARK BLVD STE E-214
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6741
Practice Address - Country:US
Practice Address - Phone:954-318-6590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN