Individual
JILLIAN L RICARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
926 SE BELFAST AVENUE, PORT SAINT LUCIE, FL 34983-3498
(772) 924-5773
(772) 924-5773
Mailing address
926 SE BELFAST AVE, PORT SAINT LUCIE, FL 34983-3914
(772) 924-5773
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
FL
171WH0202X
Home Modifications Contractor
Primary
CBC035798
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CBC035798
CERTIFIED BUILDING CONTRACTOR
FL
Enumeration date
10/23/2017
Last updated
06/30/2022
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