Individual
RICARDO F IZURIETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 SHIRCLIFF WAY, SUITE 120, JACKSONVILLE, FL 32204-4753
(904) 619-2006
(904) 619-2624
Mailing address
1893 KINGSLEY AVE, STE C, ORANGE PARK, FL 32073-4491
(904) 276-2044
(904) 276-2106
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME80907
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME80907
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262071500
—
FL
01
—
35810Y
MEDICARE PTAN
FL
Enumeration date
07/14/2006
Last updated
01/23/2012
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