Healthcare Provider Details

I. General information

NPI: 1508084443
Provider Name (Legal Business Name): HOBART K. RICHEY, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 THE RIALTO
VENICE FL
34285-3524
US

IV. Provider business mailing address

728 THE RIALTO
VENICE FL
34285-3524
US

V. Phone/Fax

Practice location:
  • Phone: 941-484-2246
  • Fax: 941-485-7421
Mailing address:
  • Phone: 941-484-2246
  • Fax: 941-485-7421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME0044811
License Number StateFL

VIII. Authorized Official

Name: HOBART KAYE RICHEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 941-484-2246