Basic Information
Provider Information
NPI: 1003804832
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RICHTER
FirstName: PAUL
MiddleName: ARTHUR
NamePrefix: DR.
NameSuffix:  
Credential: DPM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7926 W HILLSBOROUGH AVE
Address2: SUITE G
City: TAMPA
State: FL
PostalCode: 336154600
CountryCode: US
TelephoneNumber: 8138869180
FaxNumber: 8138889093
Practice Location
Address1: 7926 W HILLSBOROUGH AVE
Address2: SUITE G
City: TAMPA
State: FL
PostalCode: 336154600
CountryCode: US
TelephoneNumber: 8138869180
FaxNumber: 8138889093
Other Information
ProviderEnumerationDate: 10/06/2005
LastUpdateDate: 04/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213E00000XPO OOO1517FLY Podiatric Medicine & Surgery Service ProvidersPodiatrist 
213ES0131XPO1517FLN Podiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery

ID Information
IDTypeStateIssuerDescription
10400320005FL MEDICAID
48000260501FLRAILROAD MEDICAREOTHER


Home