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NPI Code Detail

MEDICARE: DR. RICHARD EDWARD LOSARDO MD

MEDICARE:  DR. RICHARD EDWARD LOSARDO  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
12084P0804XChild & Adolescent Psychiatry PhysicianME61588FL
22084P0800XPsychiatry PhysicianME61588FL

General Provider Information

NPI Number : 1861464794
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD EDWARD LOSARDO MD
Provider Business Mailing Address
First Line : 2740 SW MARTIN DOWNS BLVD
Second Line : #305
City : PALM CITY
State : FL
Zip : 34990-6046
Country : US
Telephone Number : 772-286-8826
Fax Number : 772-283-5531
Provider Business Practice Location Address
First Line : 789 SW FEDERAL HWY
Second Line : SUITE 213
City : STUART
State : FL
Zip : 34994-2962
Country : US
Telephone Number : 772-286-8826
Fax Number : 772-283-5531
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2006
Last Update Date : 11/30/2011

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Directions to “ DR. RICHARD EDWARD LOSARDO MD” Practice Location

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