Provider Demographics
NPI:1316100548
Name:RICHARD F. LAMACCHIA, PHD, PA
Entity type:Organization
Organization Name:RICHARD F. LAMACCHIA, PHD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:LAMACCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:321-266-9895
Mailing Address - Street 1:1980 N ATLANTIC AVE
Mailing Address - Street 2:SUITE 515
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-5213
Mailing Address - Country:US
Mailing Address - Phone:321-266-9895
Mailing Address - Fax:
Practice Address - Street 1:1980 N ATLANTIC AVE
Practice Address - Street 2:SUITE 515
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-5213
Practice Address - Country:US
Practice Address - Phone:321-266-9895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5573261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)