Provider Demographics
NPI:1356677371
Name:RICANO, RONAL R (PA)
Entity Type:Individual
Prefix:MR
First Name:RONAL
Middle Name:R
Last Name:RICANO
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:3661 SOUTH MIAMI AVENUE
Mailing Address - Street 2:SUITE 805
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4214
Mailing Address - Country:US
Mailing Address - Phone:305-856-7333
Mailing Address - Fax:305-856-8030
Practice Address - Street 1:3661 S MIAMI AVE
Practice Address - Street 2:SUITE 805
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4236
Practice Address - Country:US
Practice Address - Phone:305-856-7333
Practice Address - Fax:305-856-8030
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9105249363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical