Provider Demographics
NPI:1497762017
Name:LERNER, RICHARD DAVID (DC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DAVID
Last Name:LERNER
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 1:11241 E COLONIAL DR STE 210
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-4562
Mailing Address - Country:US
Mailing Address - Phone:407-275-9176
Mailing Address - Fax:407-275-9706
Practice Address - Street 1:11241 E COLONIAL DR STE 210
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-4562
Practice Address - Country:US
Practice Address - Phone:407-275-9176
Practice Address - Fax:407-275-9706
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8605111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89195OtherBCBS