Provider Demographics
NPI:1891729562
Name:FEIBELMAN, RICHARD Y (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:Y
Last Name:FEIBELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 ZEAGLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-3815
Mailing Address - Country:US
Mailing Address - Phone:386-530-2749
Mailing Address - Fax:855-313-6017
Practice Address - Street 1:414 ZEAGLER DRIVE
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3815
Practice Address - Country:US
Practice Address - Phone:386-530-2749
Practice Address - Fax:855-313-6017
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38708207RC0200X, 207RP1001X
FLME0038708207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL041509000Medicaid
FL41503000Medicaid
FL79726VMedicare PIN
FL79726WMedicare ID - Type Unspecified
FL79726UMedicare PIN