RICHARD DELLERSON (NPI# 1700990215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700990215 |
| Entity Type | Individual |
| Full Name | RICHARD DELLERSON |
| Credential | M.D. |
| Practice Address |
1620 S Ocean Ln Apt 236 Ft Lauderdale FL 33316-3327 |
| Practice Telephone | 9548680468 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2013-12-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | ME14359 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 048560800 | 05 |
| Street Address |
1620 S OCEAN LN APT 236 |
| City | FT LAUDERDALE |
| State | FL |
| Zip Code | 33316-3327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064040 | Jonathan David Ortiz | Behavior Technician | 1717 Se 4 Ave, Fort Lauderdale, FL 33316 | 2020-05-15 |
| 1306311626 | Gateway Recovery Center, LLC | Counselor | 1421 Sw 4th Avenue, Suite B, Fort Lauderdale, FL 33316 | 2018-10-13 |
| 1588141626 | Natan Bastoky | Family Medicine | 1600 S Andrews Ave # Gme, Fort Lauderdale, FL 33316 | 2018-07-22 |
| 1104320126 | Kathleen Kanani Graham | Pharmacist | 1401 S. Federal Highway, Ft. Lauderdale, FL 33316 | 2018-03-23 |
| 1093224271 | Lacosta Therapy, LLC | Behavioral Analyst | 412 Se 15 St., #4, Ft. Lauderdale, FL 33316 | 2017-09-20 |
| 1124560370 | Yulia Rybalka | Pharmacist | 217 Se 10th Street, Ft Lauderdale, FL 33316 | 2016-11-04 |
| 1730635376 | Brian Alexander Reyes | Specialist/Technologist | 303 Se 3rd Ave, Ft Lauderdale, FL 33316 | 2016-09-01 |
| 1649726282 | Jennifer Tabares | Specialist/Technologist | 303 Southeast 3rd Av, Fort Lauderdale, FL 33316 | 2016-09-01 |
| 1609236850 | Diane Nicole Shilling | Nurse Practitioner | 1001 South Andrews Avenue, Suite 100, Ft. Lauderdale, FL 33316 | 2016-03-01 |
| 1396113239 | Victoria Rosado | Adult Companion | 150 Se 12th Street, 401(b), Fort Lauderdale, FL 33316 | 2015-09-09 |
| Find all providers in zip 33316 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578593232 | Sean M Tierney | Emergency Medicine | 6451 N Federal Hwy Ste 800, Ft Lauderdale, FL 33308-1409 | 2006-07-05 |
| 1184693400 | John L. Abt | Emergency Medicine | 9604 Southern Pines Court, Ft Lauderdale, FL 33328-6909 | 2006-03-17 |
| 1164495073 | Peter Freedland | Emergency Medicine | 5771 Bayview Dr, Ft Lauderdale, FL 33308-2830 | 2006-02-10 |
| 1700865433 | James Albert Staab | Emergency Medicine | 2901 Ne 26th Place, Ft Lauderdale, FL 33306 | 2006-01-11 |
| 1366431546 | Anita Renee Vander Heyden | Emergency Medicine | 1317 Mandarin Isle, Ft Lauderdale, FL 33315-1648 | 2005-10-19 |
| 1669468153 | Samuel Chukwuma | Emergency Medicine | 6401 N Federal Hwy, Imperial Point Ed, Ft Lauderdale, FL 33308-1405 | 2005-09-21 |
| 1760485437 | Mary Mailloux | Emergency Medicine | 3333 W Commercial Blvd, Ste 210, Ft Lauderdale, FL 33309-3407 | 2005-05-24 |
| 1518282714 | Stavros Papandreou | Emergency Medicine | 4109 N Federal Hwy, Ft Lauderdale, FL 33308-5530 | 2010-03-30 |
| 1457588618 | Peter Nicholas Gottschalk | Emergency Medicine | 6451 N Federal Hwy, Ste 800, Ft Lauderdale, FL 33308-1402 | 2009-06-16 |
| 1821234402 | Jean-paul O Sorondo | Emergency Medicine | 1600 S Andrews Ave, Ft Lauderdale, FL 33316-2510 | 2009-01-02 |
| Find all providers in FT LAUDERDALE | ||||
| City | FT LAUDERDALE |
| Zip Code | 33316 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.