MEDICARE: DR. RICHARD JAY PRICE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	ME0040185	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215933189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD JAY PRICE MD

Provider Business Mailing Address
First Line	:	3365 BURNS RD
Second Line	:	SUITE 207
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4303
Country	:	US
Telephone Number	:	561-626-5606
Fax Number	:	561-626-6376

Provider Business Practice Location Address
First Line	:	3365 BURNS RD
Second Line	:	SUITE 207
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4303
Country	:	US
Telephone Number	:	561-626-5606
Fax Number	:	561-626-6376

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	09/21/2010

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