Provider Demographics
NPI:1083590137
Name:VIAUD, RICHARDSON KOVALSKI
Entity type:Individual
Prefix:
First Name:RICHARDSON
Middle Name:KOVALSKI
Last Name:VIAUD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RICHARDSON
Other - Middle Name:KOVALSKI
Other - Last Name:PIERRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4869 NW 124TH WAY
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3464
Mailing Address - Country:US
Mailing Address - Phone:786-269-1398
Mailing Address - Fax:
Practice Address - Street 1:4869 NW 124TH WAY
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3464
Practice Address - Country:US
Practice Address - Phone:786-269-1398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11030176363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care