Individual
DENISE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 SE 12TH ST, HOMESTEAD, FL 33035-2161
(786) 973-3223
Mailing address
2501 SE 12TH ST, HOMESTEAD, FL 33035-2161
(786) 973-3223
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5244459
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108858400
—
FL
Enumeration date
03/14/2021
Last updated
03/14/2021
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