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General NPI Number Information
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NPI Number | 1831118595
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Entity Type | Individual
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Provider Name | CLEVELAND ABBE RICKARDS P.A.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 1820 58TH AVE STE 110
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City | VERO BEACH
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State | FL
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Zip | 32966-4675
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Country | US
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Telephone | 772-257-3200
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Fax | 772-257-0187
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Provider Business Mailing Address
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Address Line | 1820 58TH AVE STE 110
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City | VERO BEACH
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State | FL
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Zip | 32966-4675
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Country | US
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Telephone | 772-257-3200
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Fax | 772-257-0187
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 55-0030638
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9112293
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License Number State | FL
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