Provider Demographics
NPI:1346449220
Name:ESPINOSA, RICARDO (PA)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4483 NW 36TH ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7260
Mailing Address - Country:US
Mailing Address - Phone:305-888-7555
Mailing Address - Fax:305-888-7410
Practice Address - Street 1:6221 NW 36TH ST
Practice Address - Street 2:
Practice Address - City:VIRGINIA GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33166-7026
Practice Address - Country:US
Practice Address - Phone:305-871-3627
Practice Address - Fax:305-871-7569
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA 9100094363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant