Provider Demographics
NPI:1386239515
Name:WELSH, RICHARD
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:WELSH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3552 BRICKELL CT
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-8807
Mailing Address - Country:US
Mailing Address - Phone:813-836-5264
Mailing Address - Fax:
Practice Address - Street 1:3552 BRICKELL CT
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-8807
Practice Address - Country:US
Practice Address - Phone:813-836-5264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9181994163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse