Provider Demographics
NPI:1730155961
Name:UNGER, RICHARD MAHLON JR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MAHLON
Last Name:UNGER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32902-0459
Mailing Address - Country:US
Mailing Address - Phone:321-725-6999
Mailing Address - Fax:321-725-6981
Practice Address - Street 1:116 SILVER PALM AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3172
Practice Address - Country:US
Practice Address - Phone:321-725-6999
Practice Address - Fax:321-725-6981
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME801682084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259417000Medicaid
FLH13684Medicare UPIN
FLE3973YMedicare PIN