Provider Demographics
NPI:1275150484
Name:FROST, RICHARD S (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:FROST
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 E BAY DR STE 13
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-2467
Mailing Address - Country:US
Mailing Address - Phone:727-530-7778
Mailing Address - Fax:727-530-7797
Practice Address - Street 1:2480 E BAY DR STE 13
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-2467
Practice Address - Country:US
Practice Address - Phone:727-530-7778
Practice Address - Fax:727-530-7797
Is Sole Proprietor?:No
Enumeration Date:2020-07-03
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5383111N00000X
FLCH12646111NI0013X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5383OtherCHIROPRACTIC PHYSICIAN
FLCH12646OtherMEDICAL LICENSE