Provider Demographics
NPI:1043022544
Name:RAV CLINIC INC
Entity type:Organization
Organization Name:RAV CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:YAIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIO RAVELO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-413-7593
Mailing Address - Street 1:6367 TRAILS OF FOXFORD CT
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-5133
Mailing Address - Country:US
Mailing Address - Phone:786-413-7593
Mailing Address - Fax:
Practice Address - Street 1:6367 TRAILS OF FOXFORD CT
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-5133
Practice Address - Country:US
Practice Address - Phone:786-413-7593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care