Provider Demographics
NPI:1184500258
Name:THRIVE RX LLC
Entity type:Organization
Organization Name:THRIVE RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANDHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KISWANI-BARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-300-4094
Mailing Address - Street 1:2680 RIVIERA CT
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33332-3419
Mailing Address - Country:US
Mailing Address - Phone:954-300-4094
Mailing Address - Fax:
Practice Address - Street 1:2680 RIVIERA CT
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33332-3419
Practice Address - Country:US
Practice Address - Phone:917-603-5585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty