Gaines, Richard Kenneth

Gaines, Richard Kenneth is an individual health care provider with primary practice located at 1075 Mason Ave , Daytona Beach FL 32117-4611. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Gaines, Richard Kenneth can be contacted via phone (386) 255-4596.

Contact Information

Primary practice address
1075 Mason Ave Daytona Beach FL 32117-4611
Phone: (386) 255-4596
Fax: (386) 258-3561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X ME60285 Florida
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X ME60285 Florida

Profile Details

NPI number 1952355497
LBN Legal business name Gaines, Richard Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Aug 9th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952355497 NPPES
Florida MEDICAID 013894900

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