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General NPI Number Information
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NPI Number | 1003281221
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Entity Type | Organization
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Legal Business Name | JOSEPH LARUE RICHTER
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Dates
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Enumeration Date | 12/14/2015
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Last Update Date | 12/14/2015
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Provider Practice Location Address
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Address Line | 2007 W REYNOLDS ST
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City | PLANT CITY
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State | FL
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Zip | 33563-4743
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Country | US
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Telephone | 813-754-4242
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Fax | 813-752-0512
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Provider Business Mailing Address
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Address Line | 2007 W REYNOLDS ST
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City | PLANT CITY
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State | FL
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Zip | 33563-4743
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Country | US
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Telephone | 813-754-4242
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Fax | 813-752-0512
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. JOSEPH LARUE RICHTER
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Credential | M.D.
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Telephone | 813-754-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0043496
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License Number State | FL
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