Provider Demographics
NPI:1932118932
Name:RAI CARE CENTERS OF FLORIDA I, LLC
Entity Type:Organization
Organization Name:RAI CARE CENTERS OF FLORIDA I, LLC
Other - Org Name:RAI - US 19 N - PALM HARBOR/CLEARWATER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:29296 US HIGHWAY 19 N STE 1
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2104
Mailing Address - Country:US
Mailing Address - Phone:727-785-9036
Mailing Address - Fax:727-772-8027
Practice Address - Street 1:29296 US HIGHWAY 19 N STE 1
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2104
Practice Address - Country:US
Practice Address - Phone:727-785-9036
Practice Address - Fax:727-772-8027
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-07
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL891164900Medicaid
FLV1QOtherBCBS
FL5674393OtherAETNA
FL5674393OtherAETNA
FL891164900Medicaid
FL=========FOtherHUMANA