MEDICARE: RICHARD M CAPRIOTTI

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	103TC0700X	Clinical Psychologist	PY0004367	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	73830	OTHER	FL	BCBS
2	614293	OTHER	FL	AMERIHEALTH
3	9610918	OTHER	FL	GHI

General Provider Information

NPI Number	:	1659454346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD M CAPRIOTTI

Provider Business Mailing Address
First Line	:	1801 ARLINGTON ST
Second Line	:	STE 1
City	:	SARASOTA
State	:	FL
Zip	:	34239-3502
Country	:	US
Telephone Number	:	941-917-6101
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 ARLINGTON ST
Second Line	:	SUITE 1
City	:	SARASOTA
State	:	FL
Zip	:	34239-3502
Country	:	US
Telephone Number	:	941-917-6101
Fax Number	:

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	03/05/2008

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