Provider Demographics
NPI:1427495514
Name:RTC
Entity type:Organization
Organization Name:RTC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESDIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSCOSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-447-9358
Mailing Address - Street 1:5342 CLARK RD
Mailing Address - Street 2:STE 166
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3227
Mailing Address - Country:US
Mailing Address - Phone:941-447-9358
Mailing Address - Fax:
Practice Address - Street 1:5342 CLARK RD
Practice Address - Street 2:STE 166
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3227
Practice Address - Country:US
Practice Address - Phone:941-447-9358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty