Organization
BOCA RATON PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD CANNON PHELPS DO (OWNER/PSYCHIATRIST)
(843) 870-2779
Entity
Organization
Contact information
Practice address
9980 CENTRAL PARK BLVD N STE 210, BOCA RATON, FL 33428-1703
(561) 342-8822
(561) 342-8985
Mailing address
7887 BLUE SAGE WAY, PARKLAND, FL 33076-4450
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
OS12896
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942490016
TYPE 1 NPI
—
Enumeration date
07/18/2017
Last updated
09/03/2019
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