Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 27369 | FL |
N | 2251S0007X | Physical Therapist - Sports | 27369 | FL |
N | 2251X0800X | Physical Therapist - Orthopedic | 27369 | FL |
NPI | 1114355054 |
---|---|
Provider Name | Dr. Julian Benjamin Richards |
First Address | Davie, FL 33328-3861 |
Second Address | Davie, FL 33328-3861 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2013 |
Last Update Date | 30/10/2013 |