Healthcare Provider Details

I. General information

NPI: 1093634339
Provider Name (Legal Business Name): RICKY HECHEVARRIA PM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13595 86TH RD N
WEST PALM BEACH FL
33412-2316
US

IV. Provider business mailing address

13595 86TH RD N
WEST PALM BEACH FL
33412-2316
US

V. Phone/Fax

Practice location:
  • Phone: 561-827-8111
  • Fax:
Mailing address:
  • Phone: 561-207-1342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number544405
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: