Individual
PAT RICALDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS MD
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
ME88289
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
DN16594
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075756001
—
FL
Enumeration date
08/20/2006
Last updated
06/14/2022
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