Provider Demographics
NPI:1437118676
Name:RICHARD A CAPPIELLO M D P A
Entity Type:Organization
Organization Name:RICHARD A CAPPIELLO M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAPPIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-737-1947
Mailing Address - Street 1:8188 JOG RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2952
Mailing Address - Country:US
Mailing Address - Phone:561-737-1947
Mailing Address - Fax:561-737-9074
Practice Address - Street 1:8188 JOG RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-2952
Practice Address - Country:US
Practice Address - Phone:561-737-1947
Practice Address - Fax:561-737-9074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 45761207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6314550001Medicare NSC
FLK5406Medicare PIN