Individual
RICHARD BERTHELOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2521 MADRID WAY S, ST PETERSBURG, FL 33712-3933
(727) 642-5448
Mailing address
2521 MADRID WAY S, ST PETERSBURG, FL 33712-3933
(727) 642-5448
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
253Z00000X
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447602024
NPI
—
Enumeration date
03/18/2021
Last updated
03/18/2021
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