Provider Demographics
NPI:1346357191
Name:RICHFIELD, MARIE T (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:T
Last Name:RICHFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 49TH ST N
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2148
Mailing Address - Country:US
Mailing Address - Phone:727-527-8788
Mailing Address - Fax:727-527-8828
Practice Address - Street 1:6006 49TH ST N STE 120
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2149
Practice Address - Country:US
Practice Address - Phone:727-527-8788
Practice Address - Fax:727-527-8828
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0038482207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL068490200Medicaid
FL62414XMedicare ID - Type Unspecified
FLD57444Medicare UPIN