Provider Demographics
NPI:1194780452
Name:RICE, ROBERT PATRICK (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PATRICK
Last Name:RICE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2888 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-4462
Mailing Address - Country:US
Mailing Address - Phone:904-321-0002
Mailing Address - Fax:
Practice Address - Street 1:2888 S 8TH ST
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-4462
Practice Address - Country:US
Practice Address - Phone:904-321-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8447111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ104772Medicare ID - Type UnspecifiedMEDICARE
AZU92541Medicare UPIN
FL70076YMedicare UPIN