Provider Demographics
NPI:1790210375
Name:RDR OPTOMETRIC CARE, PA
Entity Type:Organization
Organization Name:RDR OPTOMETRIC CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:DELMORAL
Authorized Official - Last Name:RUDOLFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-219-0788
Mailing Address - Street 1:2213 GREYSTONE LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-6004
Mailing Address - Country:US
Mailing Address - Phone:786-546-4030
Mailing Address - Fax:
Practice Address - Street 1:3535 APALACHEE PKWY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311-5330
Practice Address - Country:US
Practice Address - Phone:850-219-0788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC0003197152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty