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General NPI Number Information
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NPI Number | 1578685491
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Entity Type | Individual
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Provider Name | RICHARD MICHAEL COCCHIERI DDS
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 121 K D REVELL RD
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City | WAUCHULA
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State | FL
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Zip | 33873-2051
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Country | US
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Telephone | 863-291-5110
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Fax | 863-291-5128
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Provider Business Mailing Address
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Address Line | 47 5TH ST NW
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4672
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Country | US
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Telephone | 866-234-8534
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | HAD 79
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License Number State | FL
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