Provider Demographics
NPI:1083077515
Name:MURPHY, RICHARD DYLAN (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DYLAN
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15750 NEW HAMPSHIRE CT STE D
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4100
Mailing Address - Country:US
Mailing Address - Phone:239-395-2434
Mailing Address - Fax:239-395-2494
Practice Address - Street 1:15750 NEW HAMPSHIRE CT STE D
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4100
Practice Address - Country:US
Practice Address - Phone:239-395-2434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04571207R00000X
390200000X
FLOS15941207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program