Organization
FLORIDA CRANIOFACIAL INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAT RICALDE MD, DDS (OWNER)
(813) 870-6000
Entity
Organization
Contact information
Practice address
4200 N ARMENIA AVE STE 3, TAMPA, FL 33607-6451
(813) 870-6000
(813) 870-6015
Mailing address
4200 N ARMENIA AVE STE 3, TAMPA, FL 33607-6451
(813) 870-6000
(813) 870-6015
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
DN16594
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
ME88289
FL
Other
Enumeration date
11/01/2006
Last updated
06/18/2024
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