Healthcare Provider Details

I. General information

NPI: 1376539312
Provider Name (Legal Business Name): RICHARD D CURTIS MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 09/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 EAGLE HARBOR PARKWAY SUITE A
FLEMING ISLAND FL
32003-4323
US

IV. Provider business mailing address

11945 SAN JOSE BLVD BLDG 300
JACKSONVILLE FL
32223-1627
US

V. Phone/Fax

Practice location:
  • Phone: 904-215-2422
  • Fax: 904-215-6122
Mailing address:
  • Phone: 904-396-1725
  • Fax: 904-399-1717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberME86051
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME86051
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: