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Mr. Richard Close

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NPI Number Detailed Information

Provider Information:

Name: Mr. Richard Close
Gender: M
Provider License Number If Given: RN2726872

NPI Information:

NPI: 1154324382
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/23/2010

Provider Business Mailing Address:

Address: 9050 PINES BLVD STE 200
Pembroke Pines, FL 33024
Phone Number: 9544374800
Fax Number: 9544376628

Provider Business Practice Location Address:

Address: 3501 JOHNSON ST
Hollywood, FL 33021
Phone Number: 9549872000
Fax Number: 9544376628

Provider Taxonomy:

Primary: 363L00000X
Secondary (if any):
State: FL

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