Healthcare Provider Details

I. General information

NPI: 1780116863
Provider Name (Legal Business Name): RICARDO PLATA AGUILAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 WESTON RD
WESTON FL
33331-3602
US

IV. Provider business mailing address

16717 SAPPHIRE SPGS
WESTON FL
33331-3173
US

V. Phone/Fax

Practice location:
  • Phone: 954-659-5000
  • Fax:
Mailing address:
  • Phone: 786-222-6854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME146776
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: