Provider Demographics
NPI:1922602820
Name:RASCO MEDICAL GROUP INC
Entity Type:Organization
Organization Name:RASCO MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:C
Authorized Official - Last Name:RASCO
Authorized Official - Suffix:
Authorized Official - Credentials:ACN
Authorized Official - Phone:305-987-9628
Mailing Address - Street 1:5362 W 20TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2023
Mailing Address - Country:US
Mailing Address - Phone:305-987-9628
Mailing Address - Fax:
Practice Address - Street 1:441 SW 17TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3626
Practice Address - Country:US
Practice Address - Phone:786-663-5229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty