Individual
MR. RICARDO JORGE SOUZA LEAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
104 WOODLAND DR, LANCASTER, SC 29720-4707
(803) 285-5441
(803) 285-7509
Mailing address
104 WOODLAND DR, LANCASTER, SC 29720-4707
(803) 285-5441
(803) 285-7509
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18218
SC
363LF0000X
Family Nurse Practitioner
225875
NC
Other
Enumeration date
05/03/2013
Last updated
07/19/2023
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