Organization
R ROBERT EASTRIDGE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH ROBERT EASTRIDGE MD (PHYSICIAN PRESIDENT)
(561) 622-4900
Entity
Organization
Contact information
Practice address
3355 BURNS ROAD, SUITE 103, PALM BEACH GARDENS, FL 33410-4354
(561) 622-4900
(561) 622-0186
Mailing address
3355 BURNS ROAD, SUITE 103, PALM BEACH GARDENS, FL 33410-4354
(561) 622-4900
(561) 622-0186
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME22718
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1725514
SIGNA
FL
01
—
4600807
AETNA
FL
01
—
P00343456
RAILROAD MEDICARE
FL
01
—
P1695816
OXFORD HEALTH PLAN
FL
Enumeration date
11/09/2006
Last updated
08/03/2007
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