Daniel D Richardson, O.D., P.A.
Individual provider Active NPI Optometrist · Sumterville, FL
NPI 1851464291 · NPPES record last updated Nov 10, 2010
Key facts
- NPI
- 1851464291
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OPCOO1048 (FL)
- Practice address
- 2405 County Road 526 E
Sumterville, FL 33585-5179 - Phone
- (352) 793-2512
- Fax
- (352) 793-2445
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPCOO1048 | FL | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPCOO1048 | FL | Yes |
Addresses
Primary practice location
2405 County Road 526 E
Sumterville, FL 33585-5179
Mailing address
2405 County Road 526 E
Sumterville, FL 33585-5179
Phone (352) 793-2512
Other providers in Sumterville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.