Provider Demographics
NPI:1639197965
Name:DALY, RICHARD JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAMES
Last Name:DALY
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 1:1106 DRUID RD S
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3846
Mailing Address - Country:US
Mailing Address - Phone:727-584-6266
Mailing Address - Fax:727-581-1575
Practice Address - Street 1:1106 DRUID RD S
Practice Address - Street 2:SUITE 201
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3846
Practice Address - Country:US
Practice Address - Phone:727-584-6266
Practice Address - Fax:727-581-1575
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME289452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2581949-00Medicaid
FL3734463-00Medicaid
FL30242Medicare ID - Type UnspecifiedINDIVIDUAL ID #
FL2581949-00Medicaid