Provider Demographics
NPI:1710518477
Name:MOSS, RICHARD D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:MOSS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 NW 68 MANOR
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-1478
Mailing Address - Country:US
Mailing Address - Phone:954-592-1787
Mailing Address - Fax:
Practice Address - Street 1:160 SW 12 AVENUE, SUITE 101 D
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442
Practice Address - Country:US
Practice Address - Phone:954-725-0222
Practice Address - Fax:954-725-8811
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-31
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS210291835P2201X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care