Individual
RICARDO I VICUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1625 SE 3RD AVE STE 300, FORT LAUDERDALE, FL 33316-2521
(954) 355-5001
(954) 355-4881
Mailing address
1608 SE 3RD AVE FL 3, FORT LAUDERDALE, FL 33316-2564
(954) 355-5001
(954) 355-4881
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME94407
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME94407
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001070800
—
FL
01
—
44058
FL BLUE
FL
01
—
P02626937
MEDICARE RR
FL
Enumeration date
02/07/2007
Last updated
07/23/2025
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