NPI 1033589429
Richard Lee Colonel
Practice location
- Address
- 143 Melrose Landing Dr, Hawthorne, FL 32640-4417
- Phone
- (352) 642-5085
- Fax
- (877) 481-8035
- Mailing address
- PO Box 571, Hawthorne, FL 32640-0571
Registered specialties
Driver
Primary
Registry record
- NPI
- 1033589429
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 29 Sep 2015
- Record last updated
- 29 Sep 2015
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.