Individual
WILLIE FORREST RICHARDSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 BAYVIEW DR, FORT LAUDERDALE, FL 33304-2505
(954) 537-4106
(954) 537-4186
Mailing address
1120 BAYVIEW DR, FORT LAUDERDALE, FL 33304-2505
(954) 537-4106
(954) 537-4186
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME94167
FL
Other
Enumeration date
08/28/2006
Last updated
11/03/2011
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