Individual ProviderRichard SecundaDentistDental ProvidersPractice Address105 Cypress Point Parkway, Suite A, Palm Coast, FL 32164(386) 445-6677PECOS EnrollmentBased on the most recent information from CMS, provider Richard Secunda is legally eligible to order and refer claims for Part B, HHA and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1881727253Provider TypeIndividualFull NameSecunda, RichardGenderMaleSole ProprietorNoEnumeration Date3/14/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address105 Cypress Point Parkway, Suite A, Palm Coast, FL 32164Phone(386) 445-6677FaxUnlisted FaxMailing LocationMailing Address105 Cypress Point Parkway, Suite A, Palm Coast, FL 32164Phone(386) 445-6677FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense11694Florida