Individual
DR. ELLIOTT RICHELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 MARSH LANDING PKWY STE 112, JACKSONVILLE BEACH, FL 32250-2407
(904) 456-0002
(904) 373-0894
Mailing address
1300 MARSH LANDING PKWY STE 112, JACKSONVILLE BEACH, FL 32250-2407
(904) 456-0002
(904) 373-0894
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
117284
FL
2084P0800X
Psychiatry Physician
25MA10930300
NJ
2084P0800X
Psychiatry Physician
264936
NC
2084P0800X
Psychiatry Physician
285944
MA
2084P0800X
Psychiatry Physician
61847
TN
2084P0800X
Psychiatry Physician
74291-20
WI
2084P0800X
Psychiatry Physician
EL10717
NH
2084P0800X
Psychiatry Physician
G170998
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09949
BLUECROSS/BLUESHIELD
FL
01
—
700006036
RAILROAD MEDICARE
FL
Enumeration date
10/22/2005
Last updated
12/01/2022
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