Individual
RICARDO BORNACELLI VERGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12511 WORLD PLAZA LN, BUILDING 50, FORT MYERS, FL 33907-3991
(239) 939-2622
Mailing address
12511 WORLD PLAZA LN, BUILDING 50, FORT MYERS, FL 33907-3991
(239) 939-2622
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME100663
FL
390200000X
Student in an Organized Health Care Education/Training Program
TRN8248
FL
Other
Enumeration date
09/26/2007
Last updated
09/27/2016
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