Provider Demographics
NPI:1669638904
Name:RDR SERVICES, LLC
Entity Type:Organization
Organization Name:RDR SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:RUNK
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:941-923-7318
Mailing Address - Street 1:4316 PASADENA CIR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3623
Mailing Address - Country:US
Mailing Address - Phone:941-923-7318
Mailing Address - Fax:
Practice Address - Street 1:4316 PASADENA CIR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3623
Practice Address - Country:US
Practice Address - Phone:941-923-7318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3599363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty