Individual
JUAN P RICHIUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7379
(508) 941-6330
Mailing address
PO BOX 919771, ORLANDO, FL 32891-9771
(239) 278-3600
(239) 226-4650
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
236310
MA
207V00000X
Obstetrics & Gynecology Physician
ME114613
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008606100
—
FL
Enumeration date
08/10/2007
Last updated
04/18/2024
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