Provider Demographics
NPI:1275505844
Name:FERRAZ, RICARDO JP (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:JP
Last Name:FERRAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5656 BENEVA WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-4124
Mailing Address - Country:US
Mailing Address - Phone:973-477-1952
Mailing Address - Fax:973-589-2405
Practice Address - Street 1:5656 BENEVA WOODS CIR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-4124
Practice Address - Country:US
Practice Address - Phone:973-477-1952
Practice Address - Fax:973-589-2405
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA041091002080A0000X
FLME1580632080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD03302700OtherNJ CDS NUMBER
NJ3127800Medicaid
NJ058663OtherAMERICAN BOARD OF PEDIATR
NJ312-221-5OtherECFMG NUMBER
NJ31D0108131OtherCLIA NUMBER
FLME158063OtherFL LICENSE
NJ25MA04019100OtherNJ LICENSE
NJ25MA04019100OtherNJ LICENSE
NJ25MA04019100OtherNJ LICENSE