| Organization Name: | RAI CARE CENTERS OF ST. PETERSBURG LLC |
| NPI Number: | 1003162496 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK R. FAWCETT (VP AND TREASURER) |
| Mailing Address: | 635 4th St N St Petersburg |
| State: | FL US |
| Postal Code: | 337012319 |
| Phone Number: | 7278951472 |
| Fax Number: | 7278220268 |
| NPI Enumeration Date: | 08/03/2012 |
| NPI Last Update Date: | 07/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |