Provider Demographics
NPI:1497707574
Name:DOUYON, RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:DOUYON
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 1:18503 PINES BLVD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1404
Mailing Address - Country:US
Mailing Address - Phone:954-432-3800
Mailing Address - Fax:866-404-8639
Practice Address - Street 1:18503 PINES BLVD STE 214
Practice Address - Street 2:SUITE 214
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1408
Practice Address - Country:US
Practice Address - Phone:954-432-3800
Practice Address - Fax:866-404-8639
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME608112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252767700Medicaid
FLA61844Medicare UPIN