Organization
WILL RICHARDSON MD PA
Active
Parent organization
WILL RICHARDSON, M.D.
Other names
Natura Dermatology & Cosmetics
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILL RICHARDSON, M.D.
Authorized official
DR. WILLIE FORREST RICHARDSON JR. MD (SOLE PROPRIETOR)
(954) 537-4106
Entity
Organization
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
261QM2500X
Medical Specialty Clinic/Center
Primary
ME94167
FL
Other
Enumeration date
10/05/2006
Last updated
11/04/2009
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