Provider Demographics
NPI:1073531992
Name:GAUTHIER, RICARDO ARTHUR (AUD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:ARTHUR
Last Name:GAUTHIER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MADRID BLVD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950
Mailing Address - Country:US
Mailing Address - Phone:941-505-0400
Mailing Address - Fax:941-505-0022
Practice Address - Street 1:100 MADRID BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950
Practice Address - Country:US
Practice Address - Phone:941-505-0400
Practice Address - Fax:941-505-0022
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1182231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7615XMedicare PIN