Individual
RICHARD L NUTT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1401 W BAY DR, LARGO, FL 33770-2207
(727) 585-9500
(727) 584-1938
Mailing address
1301 2ND AVE SW, LARGO, FL 33770-3120
(727) 581-8767
(727) 586-6018
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME95431
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007307922
AETNA
FL
05
—
274989100
—
FL
01
—
53202
BCBS
FL
01
—
7118692
CIGNA
FL
01
—
P00420506
MEDICARE RAILROAD
FL
01
—
U7288Y
MEDICARE GTBA REASSIGN
FL
Enumeration date
11/18/2005
Last updated
01/06/2014
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