Basic Information
| Provider Information | |||||||||
| NPI: | 1114135001 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DREIZE | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 661057 | ||||||||
| Address2: | |||||||||
| City: | MIAMI SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 332661057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7863503358 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1695 NW 9TH AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331361409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3053557147 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 01/14/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | ME100712 | FL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.