Healthcare Provider Details
I. General information
NPI: 1578612149
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
6990 NW 37TH AVENUE
MIAMI FL
33147
US
IV. Provider business mailing address
4483 NW 36TH STREET SUITE 120
MIAMI FL
33166
US
V. Phone/Fax
- Phone: 305-691-5050
- Fax: 305-691-0006
- Phone: 305-888-7555
- Fax: 305-888-7404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KEVIN
J
PAGE
Title or Position: CFO/COO
Credential:
Phone: 305-888-7555