Healthcare Provider Details

I. General information

NPI: 1699889493
Provider Name (Legal Business Name): RICHARD L. DOLSEY, PHC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6221 NW 36 STREET
MIAMI FL
33166
US

IV. Provider business mailing address

4483 NW 36TH STREET SUITE 120
MIAMI FL
33166
US

V. Phone/Fax

Practice location:
  • Phone: 305-871-3627
  • Fax: 305-871-7569
Mailing address:
  • Phone: 305-888-7555
  • Fax: 305-888-7404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberOS6525
License Number StateFL

VIII. Authorized Official

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