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General NPI Number Information
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NPI Number | 1326143017
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Entity Type | Individual
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Provider Name | RICHARD LEON BRIDGEWATER MD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1951 SW 172ND AVE SUITE 201
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City | MIRAMAR
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State | FL
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Zip | 33029-5593
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Country | US
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Telephone | 954-636-8888
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Fax | 954-671-0070
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Provider Business Mailing Address
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Address Line | 3071 NW 70TH TER
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City | MIAMI
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State | FL
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Zip | 33147-6740
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Country | US
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Telephone | 954-671-0111
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Fax | 954-671-0070
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME63506
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License Number State | FL
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