Healthcare Provider Details

I. General information

NPI: 1942260781
Provider Name (Legal Business Name): RICHARD A CONLEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 03/29/2025
Certification Date: 03/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 GLADES RD STE 240
BOCA RATON FL
33431
US

IV. Provider business mailing address

660 GLADES RD STE 240
BOCA RATON FL
33431
US

V. Phone/Fax

Practice location:
  • Phone: 561-368-2005
  • Fax: 561-338-2178
Mailing address:
  • Phone: 561-368-2005
  • Fax: 561-338-2178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME45769
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME45769
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: