Provider Demographics
NPI:1477835064
Name:RICHARDS, JOSEPH A JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:RICHARDS
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4889 NW 95TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5117
Mailing Address - Country:US
Mailing Address - Phone:954-448-3579
Mailing Address - Fax:
Practice Address - Street 1:4889 NW 95TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-5117
Practice Address - Country:US
Practice Address - Phone:954-448-3579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103986363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical