Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME0066584 | FL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME0066584 | FL |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | ME0066584 | FL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME0066584 | FL |
NPI | 1063472108 |
---|---|
Provider Name | Richard Victor Abdo |
First Address | Clearwater, FL 33756-4070 |
Second Address | Clearwater, FL 33756-4070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 27/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
375645900 | (05) | FL |
B98001 | (02) | FL |