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General NPI Number Information
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NPI Number | 1174582969
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Entity Type | Individual
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Provider Name | RICARDO PASCUAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 1120 STATE ROAD 436 SUITE 1200
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City | CASSELBERRY
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State | FL
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Zip | 32707-6100
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Country | US
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Telephone | 407-322-8645
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Fax | 407-330-5074
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Provider Business Mailing Address
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Address Line | 4930 LAKE MARY BLVD
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City | SANFORD
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State | FL
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Zip | 32771-6012
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Country | US
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Telephone | 407-322-8645
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Fax | 407-330-5074
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN767
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License Number State | FL
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