Healthcare Provider Details

I. General information

NPI: 1225580855
Provider Name (Legal Business Name): RICARDO ALLEGUES DE ARMAS SR. MEDICAL RESIDENT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14209 SW 161ST PL
MIAMI FL
33196-6532
US

IV. Provider business mailing address

14209 SW 161ST PL
MIAMI FL
33196-6532
US

V. Phone/Fax

Practice location:
  • Phone: 786-564-7489
  • Fax:
Mailing address:
  • Phone: 786-564-7489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN44757
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number16666
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: