Organization
ANGEL ERNESTO RICO MD PA II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGEL ERNESTO RICO MD PA (PRESIDENT)
(786) 353-2098
Entity
Organization
Contact information
Practice address
1275 W 47TH PL STE 420, HIALEAH, FL 33012-3452
(863) 532-0987
(786) 353-2249
Mailing address
1275 W 47TH PL STE 420, HIALEAH, FL 33012-3452
(786) 353-2098
(786) 353-2249
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278704100
—
FL
Enumeration date
07/13/2023
Last updated
11/09/2023
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