| Rs. Va Holdings Llc | |
|
4746 Pinnacle Dr Bradenton FL 34208-8497 | |
| (917) 848-2701 | |
| Not Available |
| Full Name | Rs. Va Holdings Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4746 Pinnacle Dr, Bradenton, Florida |
| Authorized Official Name and Position | Rubena Smith (OWNER) |
| Authorized Official Contact | 9178482701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rs. Va Holdings Llc 4746 Pinnacle Dr Bradenton FL 34208-8497 Ph: (917) 848-2701 | Rs. Va Holdings Llc 4746 Pinnacle Dr Bradenton FL 34208-8497 Ph: (917) 848-2701 |
| NPI Number | 1992402499 |
|---|---|
| Provider Enumeration Date | 02/14/2023 |
| Last Update Date | 02/14/2023 |
| Medicare PECOS PAC ID | 1557724499 |
|---|---|
| Medicare Enrollment ID | O20230825000899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992402499 | NPI | - | NPPES |
| 108952300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Rubena Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649687567 PECOS PAC ID: 5092089920 Enrollment ID: I20201216000256 |
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