Individual
RICHARD J THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1223 GATEWAY DR, SUITE 2E, MELBOURNE, FL 32901-2607
(321) 312-3488
(321) 956-2542
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME129616
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018685100
—
FL
01
—
IT846Z
MEDICARE
FL
Enumeration date
09/13/2005
Last updated
03/18/2020
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