Provider Demographics
NPI:1831634260
Name:RICHARD P NATHANSON M.D.
Entity type:Organization
Organization Name:RICHARD P NATHANSON M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:NATHANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-298-6210
Mailing Address - Street 1:10000 W COLONIAL DR
Mailing Address - Street 2:SUITE 380
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3400
Mailing Address - Country:US
Mailing Address - Phone:407-298-6210
Mailing Address - Fax:407-298-6239
Practice Address - Street 1:10000 W COLONIAL DR
Practice Address - Street 2:SUITE 380
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3400
Practice Address - Country:US
Practice Address - Phone:407-298-6210
Practice Address - Fax:407-298-6239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55344207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty