Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | ME49582 | FL |
NPI | 1043341514 |
---|---|
Provider Name | Dr. Audrey Lynn Richards |
First Address | Vero Beach, FL 32960-4898 |
Second Address | Vero Beach, FL 32960-4898 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 03/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B76204 | (02) | FL |