Healthcare Provider Details

I. General information

NPI: 1003766940
Provider Name (Legal Business Name): LILIANNIS MARGARITA RICARDO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1804 OAKLEY SEAVER DR STE F
CLERMONT FL
34711-1925
US

IV. Provider business mailing address

1804 OAKLEY SEAVER DR STE F
CLERMONT FL
34711-1925
US

V. Phone/Fax

Practice location:
  • Phone: 407-499-0755
  • Fax: 949-543-2564
Mailing address:
  • Phone: 407-499-0755
  • Fax: 949-543-2564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11045038
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: