Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dale Shaquille Richardson, PA-C

Individual provider Physician Assistant · NPI 1245017540

Dale Shaquille Richardson, PA-C is a Physician Assistant in Brandon, Florida. Qualified in 2023, 3 years ago. Practices with Mori Bean and Brooks Inc, a 976-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
3
Licensed in
FL
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

671 S Kings Ave
Brandon, FL 33511-6048
Phone: (813) 972-3750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PENDING (FL)

Record details

NPI number1245017540
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 11, 2023
Last updated in NPPESSeptember 11, 2023
Certification dateSeptember 11, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Mori Bean And Brooks Inc — 976 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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