| Revolutionary Care Clinic Llc | |
|
1690 S Congress Ave Ste 205b Delray Beach FL 33445-6327 | |
| (833) 854-3131 | |
| (888) 979-8674 |
| Full Name | Revolutionary Care Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1690 S Congress Ave Ste 205b, Delray Beach, Florida |
| Authorized Official Name and Position | Jonathan Cordero (OWNER) |
| Authorized Official Contact | 8338543131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revolutionary Care Clinic Llc 1690 S Congress Ave Ste 205b Delray Beach FL 33445-6327 Ph: (833) 854-3131 | Revolutionary Care Clinic Llc 1690 S Congress Ave Ste 205b Delray Beach FL 33445-6327 Ph: (833) 854-3131 |
| NPI Number | 1457088437 |
|---|---|
| Provider Enumeration Date | 08/01/2022 |
| Last Update Date | 08/01/2023 |
| Medicare PECOS PAC ID | 6709261027 |
|---|---|
| Medicare Enrollment ID | O20220922000152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457088437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Steven Licata |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1508874439 PECOS PAC ID: 0749472116 Enrollment ID: I20101005000306 |
| Provider Name | Deborah L Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619335205 PECOS PAC ID: 8527351774 Enrollment ID: I20160726000160 |
Delray Physician Care Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2280 W Atlantic Ave, Delray Beach, FL 33445 Phone: 561-278-3134 Fax: 561-278-3922 | |
Amicus Medical Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5130 Linton Blvd, Delray Beach, FL 33484 Phone: 561-725-5630 Fax: 561-496-0541 | |
Cogent Healthcare Of Pensacola Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5352 Linton Blvd, Delray Beach, FL 33484 Phone: 561-498-4440 | |
Elena Yamaguchi Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13550 Jog Rd, Suite 202a, Delray Beach, FL 33446 Phone: 561-495-9289 Fax: 561-495-9293 | |
Cohen Medical Associates Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15300 Jog Rd, Suite 205, Delray Beach, FL 33446 Phone: 561-496-7200 Fax: 561-496-7289 | |
Bhanmatie Singh Do Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5341 W Atlantic Ave Ste 300c, Delray Beach, FL 33484 Phone: 561-501-4992 Fax: 844-274-9201 | |
Delray Medical Group, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13590 S Jog Rd Ste 4, Delray Beach, FL 33446 Phone: 561-376-3140 |