Wilde, Richard Alan

Wilde, Richard Alan is an individual health care provider with primary practice located at 1854 Oak Grove Blvd , Lutz FL 33559-8605. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wilde, Richard Alan can be contacted via phone (813) 948-6133.

Contact Information

Primary practice address
1854 Oak Grove Blvd Lutz FL 33559-8605
Phone: (813) 948-6133
Fax: (813) 948-3460
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME82294 Florida

Profile Details

NPI number 1912923830
LBN Legal business name Wilde, Richard Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Jun 11th, 2021 - about 3 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 1912923830 NPPES
Florida MEDICAID 262370600

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