| Organization Name: | DR ANDREU J RICHARDSON, DC, PA |
| NPI Number: | 1235433590 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDREU J MACANDREW RICHARDSON (PRESIDENT) |
| Mailing Address: | 2450 Ne 13th Ave Wilton Manors |
| State: | FL US |
| Postal Code: | 333051304 |
| Phone Number: | 9545378898 |
| Fax Number: | 9549167205 |
| NPI Enumeration Date: | 12/30/2010 |
| NPI Last Update Date: | 12/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | CH 9030 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |