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NPI Code Detail

MEDICARE: MRS. PAMELA MICHELLE RICHARDSON DO

MEDICARE: MRS. PAMELA MICHELLE RICHARDSON DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
138-4206980OTHERFL253Z00000X

General Provider Information

NPI Number : 1548993025
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PAMELA MICHELLE RICHARDSON DO
Provider Business Mailing Address
First Line : 1800 W WASHINGTON ST
Second Line :
City : ORLANDO
State : FL
Zip : 32805-1745
Country : US
Telephone Number : 407-422-5310
Fax Number : 407-423-9021
Provider Business Practice Location Address
First Line : 1800 W WASHINGTON ST
Second Line :
City : ORLANDO
State : FL
Zip : 32805-1745
Country : US
Telephone Number : 407-422-5310
Fax Number : 407-423-9021
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2022
Last Update Date : 12/07/2022

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