Provider Demographics
NPI:1578731709
Name:RTG MEDICAL
Entity Type:Organization
Organization Name:RTG MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TOMPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:727-869-0053
Mailing Address - Street 1:10354 SMOOTH WATER DR
Mailing Address - Street 2:186
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-8804
Mailing Address - Country:US
Mailing Address - Phone:727-869-0053
Mailing Address - Fax:
Practice Address - Street 1:10354 SMOOTH WATER DR
Practice Address - Street 2:186
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-8804
Practice Address - Country:US
Practice Address - Phone:727-869-0053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5156377261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5156377OtherLPN