Healthcare Provider Details

I. General information

NPI: 1518720333
Provider Name (Legal Business Name): MERIEM RICHARDSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9030 58TH DR E STE 102
BRADENTON FL
34202-6108
US

IV. Provider business mailing address

11814 ARMADA WAY
PARRISH FL
34219-1821
US

V. Phone/Fax

Practice location:
  • Phone: 941-340-1649
  • Fax: 941-229-8802
Mailing address:
  • Phone: 941-545-6480
  • Fax: 941-229-8802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11030763
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: