Provider Demographics
NPI:1891844965
Name:RICHARD L. DOLSEY, PHC, INC.
Entity Type:Organization
Organization Name:RICHARD L. DOLSEY, PHC, INC.
Other - Org Name:PHYSICIANS HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/COO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-888-7555
Mailing Address - Street 1:4483 NW 36TH STREET
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166
Mailing Address - Country:US
Mailing Address - Phone:305-888-7555
Mailing Address - Fax:305-888-7404
Practice Address - Street 1:7887 N. KENDALL DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156
Practice Address - Country:US
Practice Address - Phone:305-279-7722
Practice Address - Fax:305-279-2090
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD L. DOLSEY, OHC, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-09
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME27131261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL91992AMedicare ID - Type Unspecified