Provider Demographics
NPI:1982325296
Name:RESTORATIVE RHEUMATOLOGY CORP
Entity Type:Organization
Organization Name:RESTORATIVE RHEUMATOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BORST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:352-723-0088
Mailing Address - Street 1:2801 SE 1ST AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0478
Mailing Address - Country:US
Mailing Address - Phone:352-723-0088
Mailing Address - Fax:352-237-0893
Practice Address - Street 1:2801 SE 1ST AVE STE 204
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0478
Practice Address - Country:US
Practice Address - Phone:352-723-0088
Practice Address - Fax:352-237-0893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty