Provider Demographics
NPI:1922556448
Name:SCAFIDI, RICHARD
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:SCAFIDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 E KENNEDY BLVD
Mailing Address - Street 2:APT 843
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3545
Mailing Address - Country:US
Mailing Address - Phone:239-777-7632
Mailing Address - Fax:
Practice Address - Street 1:1175 E KENNEDY BLVD
Practice Address - Street 2:APT 843
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-3545
Practice Address - Country:US
Practice Address - Phone:239-777-7632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 317592251X0800X
FLAL 35552255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer