MEDICARE: DR. JOSHUA ALDWYN RICHARDSON DC

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	111N00000X	Chiropractor	13589	FL

General Provider Information

NPI Number	:	1477122307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA ALDWYN RICHARDSON DC

Provider Business Mailing Address
First Line	:	8400 113TH ST
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33772-4131
Country	:	US
Telephone Number	:	727-201-4549
Fax Number	:	866-265-0201

Provider Business Practice Location Address
First Line	:	8400 113TH ST
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33772-4131
Country	:	US
Telephone Number	:	727-201-4549
Fax Number	:	866-265-0201

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

Provider Enumeration Date	:	06/24/2021
Last Update Date	:	06/24/2021

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