Provider Demographics
NPI:1487616280
Name:RCOA FLORIDA I, LLC
Entity type:Organization
Organization Name:RCOA FLORIDA I, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-477-3500
Mailing Address - Street 1:7900 GLADES RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4167
Mailing Address - Country:US
Mailing Address - Phone:561-477-3500
Mailing Address - Fax:866-293-3535
Practice Address - Street 1:16110 JOG RD
Practice Address - Street 2:SUITE 200
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2350
Practice Address - Country:US
Practice Address - Phone:561-819-6711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2843OtherBLUE CROSS BLUE SHEILD FL
FL286367OtherWELLCARE
FLV2843OtherBLUE CROSS BLUE SHEILD FL