Provider Demographics
NPI:1629072137
Name:HODES, RICHARD A (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:HODES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8521 W MCNAB RD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-3209
Mailing Address - Country:US
Mailing Address - Phone:954-721-1990
Mailing Address - Fax:954-721-1932
Practice Address - Street 1:8521 W MCNAB RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-3209
Practice Address - Country:US
Practice Address - Phone:954-721-1990
Practice Address - Fax:954-721-1932
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO953213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist