Healthcare Provider Details

I. General information

NPI: 1497076335
Provider Name (Legal Business Name): ELIZABETH R RICHTER M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BETH RICHTER M.D., PH.D.

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 01/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 BEE RIDGE RD BLDG D
SARASOTA FL
34233-1207
US

IV. Provider business mailing address

3920 BEE RIDGE RD BLDG D
SARASOTA FL
34233-1207
US

V. Phone/Fax

Practice location:
  • Phone: 941-924-0303
  • Fax: 941-924-0309
Mailing address:
  • Phone: 941-924-0303
  • Fax: 941-924-0309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberME127740
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: