Healthcare Provider Details

I. General information

NPI: 1316096076
Provider Name (Legal Business Name): RICHARD L. DOLSEY, PHC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 09/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20535 NW 2ND AVENUE SUITE 150
MIAMI FL
33169
US

IV. Provider business mailing address

4483 NW 36TH STREET SUITE 120
MIAMI FL
33166
US

V. Phone/Fax

Practice location:
  • Phone: 305-653-7720
  • Fax: 305-653-2099
Mailing address:
  • Phone: 305-888-7555
  • Fax: 305-888-7404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberME58546
License Number StateFL

VIII. Authorized Official

Name: KEVIN J PAGE
Title or Position: CFO/COO
Credential:
Phone: 305-888-7555