Provider Demographics
NPI:1043076334
Name:FRANCO, RICARDO EVERARDO
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:EVERARDO
Last Name:FRANCO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 WOODBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-1172
Mailing Address - Country:US
Mailing Address - Phone:702-521-1828
Mailing Address - Fax:
Practice Address - Street 1:5351 MONTESSOURI ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1126
Practice Address - Country:US
Practice Address - Phone:702-251-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-0796208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation