Provider Demographics
NPI:1558633941
Name:RICHARD MICHAEL DREIZE MD PL
Entity Type:Organization
Organization Name:RICHARD MICHAEL DREIZE MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:DREIZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-303-1970
Mailing Address - Street 1:PO BOX 661057
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33266-1057
Mailing Address - Country:US
Mailing Address - Phone:786-303-1970
Mailing Address - Fax:786-369-1790
Practice Address - Street 1:4005 NW 114TH AVE
Practice Address - Street 2:STE 3
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4374
Practice Address - Country:US
Practice Address - Phone:786-303-1970
Practice Address - Fax:786-369-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1007122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty