Organization
ROCK STAR REP INC
Active
Organization
ROCK STAR REP INC
Active
Other names
SOUTH WALTON MEDICAL
Organization subpart
No
Provider details
NPI number
Authorized official
PERRY MONTY REEVES (CEO)
(863) 513-0349
Entity
Organization
Contact information
Practice address
10065 US HIGHWAY 98 W, STE B 101, MIRAMAR BEACH, FL 32550-4924
(850) 837-8005
(850) 837-4352
Mailing address
5305 OAKWAY DR, LAKELAND, FL 33805-8584
(863) 513-0349
(863) 248-0453
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/10/2009
Last updated
04/09/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up