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General NPI Number Information
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NPI Number | 1043600216
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Entity Type | Organization
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Legal Business Name | RICARDO ANTONIO HENRIQUES M.D.
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 01/27/2015
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Provider Practice Location Address
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Address Line | 503 DELANNOY AVE
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City | COCOA
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State | FL
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Zip | 32922-7813
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Country | US
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Telephone | 321-631-6995
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Fax | 321-633-1004
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Provider Business Mailing Address
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Address Line | 503 DELANNOY AVE
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City | COCOA
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State | FL
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Zip | 32922-7813
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Country | US
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Telephone | 321-631-6995
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Fax | 321-633-1004
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RICARDO ANTONIO HENRIQUES
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Credential | M.D.
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Telephone | 321-631-6995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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