Provider Demographics
NPI:1184109688
Name:ROCKY RIVER HEALTHCARE
Entity type:Organization
Organization Name:ROCKY RIVER HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-269-4000
Mailing Address - Street 1:3401 W FLETCHER AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2813
Mailing Address - Country:US
Mailing Address - Phone:813-269-4000
Mailing Address - Fax:813-269-4001
Practice Address - Street 1:3401 W FLETCHER AVE STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2813
Practice Address - Country:US
Practice Address - Phone:813-269-4000
Practice Address - Fax:813-269-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental