Individual
RICK CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1800 SE TIFFANY AVE, PORT SAINT LUCIE, FL 34952-7521
(772) 398-1990
Mailing address
1800 SE TIFFANY AVE, PORT SAINT LUCIE, FL 34952-7521
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
002989
FL
Other
Enumeration date
10/02/2012
Last updated
06/02/2021
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