| R3 Integrated Health Plus Llc | |
|
949 Broadway Dunedin FL 34698-5717 | |
| (813) 417-1165 | |
| Not Available |
| Full Name | R3 Integrated Health Plus Llc |
|---|---|
| Speciality | General Practice |
| Location | 949 Broadway, Dunedin, Florida |
| Authorized Official Name and Position | Damon Stafford (SOLE MBR) |
| Authorized Official Contact | 8134171165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| R3 Integrated Health Plus Llc 949 Broadway Dunedin FL 34698-5717 Ph: () - | R3 Integrated Health Plus Llc 949 Broadway Dunedin FL 34698-5717 Ph: (813) 417-1165 |
| NPI Number | 1215525134 |
|---|---|
| Provider Enumeration Date | 01/06/2021 |
| Last Update Date | 04/06/2022 |
| Medicare PECOS PAC ID | 9133534738 |
|---|---|
| Medicare Enrollment ID | O20210211003165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215525134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Damon J Stafford |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1770650574 PECOS PAC ID: 3678468592 Enrollment ID: I20040219000339 |
| Provider Name | Jose N Peralta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215462007 PECOS PAC ID: 0941556229 Enrollment ID: I20180628000942 |
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