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General NPI Number Information
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NPI Number | 1154324382
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Entity Type | Individual
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Provider Name | RICHARD CLOSE A.R.N.P.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | MEMORIAL HOSPITAL WEST 703 N. FLAMINGO ROAD
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City | PEMBROKE PINES
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State | FL
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Zip | 33028
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Country | US
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Telephone | 954-844-7135
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N HIATUS RD STE 200
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-5213
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Country | US
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Telephone | 954-437-4800
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Fax | 954-437-6628
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN2726872
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License Number State | FL
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