Provider Demographics
NPI:1972232445
Name:RICHANI MEINHARDT, FEDOR WADI
Entity Type:Individual
Prefix:
First Name:FEDOR
Middle Name:WADI
Last Name:RICHANI MEINHARDT
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 1:360 RACQUET CLUB RD APT 102
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1121
Mailing Address - Country:US
Mailing Address - Phone:754-303-6427
Mailing Address - Fax:
Practice Address - Street 1:360 RACQUET CLUB RD APT 102
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1121
Practice Address - Country:US
Practice Address - Phone:754-303-6427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22-301246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant