Provider Demographics
NPI:1932521390
Name:KAINE, RICHARD FREDERICK (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FREDERICK
Last Name:KAINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6615 BOYNTON BEACH BLVD
Mailing Address - Street 2:PMB 343
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3526
Mailing Address - Country:US
Mailing Address - Phone:800-762-1967
Mailing Address - Fax:770-967-3070
Practice Address - Street 1:6615 BOYNTON BEACH BLVD
Practice Address - Street 2:PMB 343
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3526
Practice Address - Country:US
Practice Address - Phone:800-762-1967
Practice Address - Fax:770-967-3070
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-19
Last Update Date:2014-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA31041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine