Provider Demographics
NPI:1558004416
Name:GILMORE-BYRD, RIKKISHA (DRPH, CHES)
Entity Type:Individual
Prefix:DR
First Name:RIKKISHA
Middle Name:
Last Name:GILMORE-BYRD
Suffix:
Gender:F
Credentials:DRPH, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 KISSAM CT
Mailing Address - Street 2:
Mailing Address - City:BELLE ISLE
Mailing Address - State:FL
Mailing Address - Zip Code:32809-3587
Mailing Address - Country:US
Mailing Address - Phone:321-271-8066
Mailing Address - Fax:
Practice Address - Street 1:2501 KISSAM CT
Practice Address - Street 2:
Practice Address - City:BELLE ISLE
Practice Address - State:FL
Practice Address - Zip Code:32809-3587
Practice Address - Country:US
Practice Address - Phone:321-271-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE