Provider Demographics
NPI:1851659023
Name:RMA OF BOCA RATON LLC
Entity Type:Organization
Organization Name:RMA OF BOCA RATON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-318-6590
Mailing Address - Street 1:9980 NORTH CENTRAL PARK BLVD
Mailing Address - Street 2:SUITE 334
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1704
Mailing Address - Country:US
Mailing Address - Phone:561-488-3734
Mailing Address - Fax:561-488-3622
Practice Address - Street 1:9980 NORTH CENTRAL PARK BLVD
Practice Address - Street 2:SUITE 334
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1704
Practice Address - Country:US
Practice Address - Phone:561-488-3734
Practice Address - Fax:561-488-3622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty