Provider Demographics
NPI:1548604127
Name:ARTHRITIS & RHEUMATOLOGY CARE CENTER
Entity Type:Organization
Organization Name:ARTHRITIS & RHEUMATOLOGY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:RELAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-503-6999
Mailing Address - Street 1:PO BOX 830941
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0941
Mailing Address - Country:US
Mailing Address - Phone:904-503-6999
Mailing Address - Fax:904-503-6998
Practice Address - Street 1:915 W MONROE ST STE 301
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-1177
Practice Address - Country:US
Practice Address - Phone:904-503-6999
Practice Address - Fax:904-503-6998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91096207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270413700Medicaid
FL270413700Medicaid