| Organization Name: | RV MEDICAL CENTER, INC |
| NPI Number: | 1043582497 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REYNA L MORA (PRESIDENT) |
| Mailing Address: | 3383 Nw 7th St Ste 313 Miami |
| State: | FL US |
| Postal Code: | 331254140 |
| Phone Number: | 3053920371 |
| Fax Number: | |
| NPI Enumeration Date: | 02/01/2012 |
| NPI Last Update Date: | 03/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | AHCA HCC 9365 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |