Individual
DR. RICKEY J VIATOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23 MACK BAYOU LOOP, SUITE 200, SANTA ROSA BEACH, FL 32459-2604
(850) 278-3920
Mailing address
PO BOX 2699, PENSACOLA, FL 32513-2699
(850) 475-4500
(850) 475-4619
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME45069
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061248100
—
FL
01
—
09135
BCBS
FL
01
—
101554
AVMED
FL
01
—
P00379114
RAILROAD MEDICARE
FL
Enumeration date
06/27/2006
Last updated
03/17/2010
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