Provider Demographics
NPI:1154359396
Name:HAYS, RICHARD MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:HAYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1397 MEDICAL PARK BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3186
Mailing Address - Country:US
Mailing Address - Phone:561-784-0202
Mailing Address - Fax:561-641-7732
Practice Address - Street 1:1397 MEDICAL PARK BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3186
Practice Address - Country:US
Practice Address - Phone:561-784-0202
Practice Address - Fax:561-641-7732
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL47994207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61528Medicare ID - Type Unspecified
FLD65292Medicare UPIN