Rivers Edge Boutique Medicine LLC
NPI #1033970454 in New Port Richey, Florida
Provider Information
- NPI Number
- 1033970454
- Entity Type
- Organization
- Organization Name
- Rivers Edge Boutique Medicine LLC
- Primary Specialty
- Family Medicine - Adult Medicine
- Enumeration Date
- Jan 22, 2024
- Last Updated
- Jan 22, 2024
Practice Location
- Address
- 5647 MAIN ST STE 1&2
- City
- New Port Richey
- State
- Florida
- ZIP Code
- 34652-2641
- Phone
- (727) 831-8376
Authorized Official
- Name
- TRACY GREENE, NP-C
- Title
- OWNER
- Phone
- (727) 342-4955
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Adult Medicine — Adult Medicine |
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