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General NPI Number Information
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NPI Number | 1003014242
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Entity Type | Organization
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Legal Business Name | RICHARD A MCLEAN MD PA
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 4101 NW 4TH ST SUITE 404
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City | PLANTATION
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State | FL
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Zip | 33317-2850
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Country | US
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Telephone | 954-792-4880
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Fax | 954-792-4881
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Provider Business Mailing Address
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Address Line | 14782 SW 176TH TER
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City | MIAMI
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State | FL
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Zip | 33187-6779
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Country | US
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Telephone | 954-599-5172
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Fax | 954-792-4880
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD A MCLEAN
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Credential | MD
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Telephone | 954-792-4880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME86503
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License Number State | FL
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