| Raveon 1947 | |
|
9040 Town Center Pkwy Lakewood Ranch FL 34202-4101 | |
| (941) 552-5656 | |
| (941) 552-5650 |
| Full Name | Raveon 1947 |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9040 Town Center Pkwy, Lakewood Ranch, Florida |
| Authorized Official Name and Position | David Louis Kaus (OWNER) |
| Authorized Official Contact | 9416850265 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Raveon 1947 9040 Town Center Pkwy Lakewood Ranch FL 34202-4101 Ph: (941) 552-5656 | Raveon 1947 9040 Town Center Pkwy Lakewood Ranch FL 34202-4101 Ph: (941) 552-5656 |
| NPI Number | 1720419062 |
|---|---|
| Provider Enumeration Date | 12/12/2013 |
| Last Update Date | 12/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720419062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Florida) | Primary |
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