# RIVERSIDE ELITE THERAPIES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174901680
- **Authorized official:** DEIRDRE ROBINSON (PARTNER)
- **Authorized official phone:** (772) 245-4444

## Contact information

- **Practice address:** 850 NW FEDERAL HWY STE 110, STUART, FL 34994-1019
- **Practice address phone:** (772) 245-4444
- **Practice address fax:** (772) 324-6559
- **Mailing address:** 850 NW FEDERAL HWY STE 110, STUART, FL 34994-1019
- **Mailing address phone:** (772) 245-4444
- **Mailing address fax:** (772) 324-6559

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | SA12968 | FL | Yes |

## Other

- **Enumeration date:** 05/15/2015
- **Last updated:** 01/29/2019