Provider Demographics
NPI:1518672385
Name:RINGSIDE MDS LLC
Entity Type:Organization
Organization Name:RINGSIDE MDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:MATHEW
Authorized Official - Last Name:HECHTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-247-2373
Mailing Address - Street 1:125 S STATE RD 7 SUITE 104 #116
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414
Mailing Address - Country:US
Mailing Address - Phone:561-247-2373
Mailing Address - Fax:561-823-3495
Practice Address - Street 1:14440 PIERSON RD
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-7673
Practice Address - Country:US
Practice Address - Phone:561-247-2373
Practice Address - Fax:561-823-3495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty