Provider Demographics
NPI:1396925111
Name:RBM MD PA
Entity type:Organization
Organization Name:RBM MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-955-1036
Mailing Address - Street 1:1961 FLOYD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2931
Mailing Address - Country:US
Mailing Address - Phone:941-955-1036
Mailing Address - Fax:941-365-5750
Practice Address - Street 1:1961 FLOYD ST
Practice Address - Street 2:SUITE B
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2931
Practice Address - Country:US
Practice Address - Phone:941-955-1036
Practice Address - Fax:941-365-5750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME23173174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1700Medicare PIN