Willie Forrest Richardson JR.
Dermatologist
1120 Bayview Dr
Fort Lauderdale
, Florida 33304-2505
Willie Forrest Richardson JR.
Dermatologist
1120 Bayview Dr
Fort Lauderdale
, Florida 33304-2505
(954) 537-4186
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Willie Forrest Richardson JR.
- 1120 Bayview Dr
- Fort Lauderdale, FL
- Zip : 33304-2505
- Fax : (954) 537-4186
- Phone : (954) 537-4106
Second Address
- Willie Forrest Richardson JR.
- 1120 Bayview Dr
- Fort Lauderdale, FL
- Zip : 33304-2505
- Fax : (954) 537-4186
- Phone : (954) 537-4106
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FAQs
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Is Willie Forrest Richardson JR. a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | ME94167 | FL |
National Provider Identifier
| NPI | 1043328230 |
|---|---|
| Provider Name | Willie Forrest Richardson JR. |
| First Address | Fort Lauderdale, FL 33304-2505 |
| Second Address | Fort Lauderdale, FL 33304-2505 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/08/2006 |
| Last Update Date | 03/11/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| I02128 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.