Provider Demographics
NPI:1619411345
Name:RICARDO, LEONARDO (ARNP)
Entity Type:Individual
Prefix:
First Name:LEONARDO
Middle Name:
Last Name:RICARDO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4524 30TH PL SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-8218
Mailing Address - Country:US
Mailing Address - Phone:239-330-0621
Mailing Address - Fax:
Practice Address - Street 1:4524 30TH PL SW
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-8218
Practice Address - Country:US
Practice Address - Phone:239-330-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9342149363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner