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General NPI Number Information
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NPI Number | 1699590398
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Entity Type | Individual
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Provider Name | SEAN ROBERT RICHARDSON APRN
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Gender | Male
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 218 9TH STREET DR W
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City | PALMETTO
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State | FL
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Zip | 34221-4802
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Country | US
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Telephone | 941-721-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 14179 CRIMSON AVE
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City | BRADENTON
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State | FL
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Zip | 34211-1613
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Country | US
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Telephone | 267-644-5981
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | APRN11035397
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License Number State | FL
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