Provider Demographics
NPI:1376622720
Name:RICHARD L FOX DO PA
Entity Type:Organization
Organization Name:RICHARD L FOX DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNERPRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-721-4300
Mailing Address - Street 1:7171 N UNIVERSITY DR STE 203
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2902
Mailing Address - Country:US
Mailing Address - Phone:954-721-4300
Mailing Address - Fax:954-721-8080
Practice Address - Street 1:7171 N UNIVERSITY DR STE 306
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2902
Practice Address - Country:US
Practice Address - Phone:954-721-4300
Practice Address - Fax:954-721-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97201207Q00000X
FLOS8487207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty