Provider Demographics
NPI:1467952861
Name:SILVA GUAL, RICARDO ENRIQUE (APRN)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:ENRIQUE
Last Name:SILVA GUAL
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13325 SW 115TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-4495
Mailing Address - Country:US
Mailing Address - Phone:954-851-4048
Mailing Address - Fax:
Practice Address - Street 1:330 SW 27TH AVE STE 305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2957
Practice Address - Country:US
Practice Address - Phone:786-953-4273
Practice Address - Fax:786-953-4473
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-13
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9428686363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology