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NPI Code Detail

MEDICARE: DR. RICHARD MICHAEL RONSISVALLE PSY.D.

MEDICARE: DR. RICHARD MICHAEL RONSISVALLE PSY.D.
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
1103T00000XPsychologistPY6964FL

General Provider Information

NPI Number : 1447499553
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD MICHAEL RONSISVALLE PSY.D.
Provider Business Mailing Address
First Line : 8249 DEVEREUX DR STE 101
Second Line :
City : MELBOURNE
State : FL
Zip : 32940-7955
Country : US
Telephone Number : 321-259-1662
Fax Number : 321-779-7729
Provider Business Practice Location Address
First Line : 8249 DEVEREUX DR STE 101
Second Line :
City : MELBOURNE
State : FL
Zip : 32940-7955
Country : US
Telephone Number : 321-259-1662
Fax Number : 321-779-7729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2009
Last Update Date : 10/18/2024

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