Provider Demographics
NPI:1821336249
Name:RESPIRATORY CARE PROVIDERS, INCORPORATED
Entity Type:Organization
Organization Name:RESPIRATORY CARE PROVIDERS, INCORPORATED
Other - Org Name:KIDS AND NURSES PPEC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCAVELLA
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:305-301-4416
Mailing Address - Street 1:5575 NW WESLEY CT
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-4232
Mailing Address - Country:US
Mailing Address - Phone:305-301-4416
Mailing Address - Fax:
Practice Address - Street 1:3660 20TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-2410
Practice Address - Country:US
Practice Address - Phone:772-226-5059
Practice Address - Fax:772-226-5082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL600810013140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL60081001Medicaid