Provider Demographics
NPI:1811088362
Name:KAINZ, RICHARD IVOR (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:IVOR
Last Name:KAINZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 CLEMWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-6904
Mailing Address - Country:US
Mailing Address - Phone:407-421-5622
Mailing Address - Fax:407-898-3352
Practice Address - Street 1:3300 CLEMWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-6904
Practice Address - Country:US
Practice Address - Phone:407-421-5622
Practice Address - Fax:407-898-3352
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4082103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPY4082OtherLICENSED PSYCHOLOGIST