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General NPI Number Information
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NPI Number | 1710400353
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Entity Type | Individual
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Provider Name | RICARDO ANTONIO RODRIGUEZ PEREZ
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Gender | Male
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 10145 NW 9TH STREET CIR APT 505
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City | MIAMI
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State | FL
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Zip | 33172-3279
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Country | US
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Telephone | 787-667-9920
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Fax |
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Provider Business Mailing Address
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Address Line | 225 CALLE VIOLETA URB. SAN FRANCISCO
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City | SAN JUAN
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State | PR
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Zip | 00927
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Country | US
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Telephone | 787-667-9920
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME155005
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License Number State | FL
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