MEDICARE: DR. RICHARD LAWRENCE SIEGEL M.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
1	207K00000X	Allergy & Immunology Physician	ME37984	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

General Provider Information

NPI Number	:	1770518938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD LAWRENCE SIEGEL M.D.

Provider Business Mailing Address
First Line	:	17407 BRIDGE HILL CT STE B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3522
Country	:	US
Telephone Number	:	813-972-3131
Fax Number	:	813-972-0773

Provider Business Practice Location Address
First Line	:	17407 BRIDGE HILL CT STE B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3522
Country	:	US
Telephone Number	:	813-972-3131
Fax Number	:	813-972-0773

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	11/22/2019

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