Individual
RICHARD FAIRFAX PELL IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
925 NE 30TH TER, SUITE 102, HOMESTEAD, FL 33033-7613
(305) 247-1701
(305) 247-1799
Mailing address
925 NE 30TH TER, SUITE 102, HOMESTEAD, FL 33033-7613
(305) 247-1701
(305) 247-1799
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME96926
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277567100
—
FL
01
—
305551
AVMED
FL
01
—
92026
BCBS
FL
01
—
SG082540
VISTA
—
Enumeration date
12/08/2005
Last updated
05/28/2013
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