Provider Demographics
NPI:1083615272
Name:HOOD, RICHARD KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:KEITH
Last Name:HOOD
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 1:8350 RIVERWALK PARK BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-8759
Mailing Address - Country:US
Mailing Address - Phone:239-482-5399
Mailing Address - Fax:239-482-5153
Practice Address - Street 1:8350 RIVERWALK PARK BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-8759
Practice Address - Country:US
Practice Address - Phone:239-482-5399
Practice Address - Fax:239-482-5153
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0075231208VP0000X
FLME75231208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254358300Medicaid
FLP00214536OtherRAILROAD MEDICARE
FLP00214536OtherRAILROAD MEDICARE
FL0425580001Medicare NSC
FLF37776Medicare UPIN
FL254358300Medicaid