Provider Demographics
NPI:1689243610
Name:FERRER, RICHARD DINIS JR
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DINIS
Last Name:FERRER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 HAWKS COVE CIR
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-8497
Mailing Address - Country:US
Mailing Address - Phone:609-972-6988
Mailing Address - Fax:
Practice Address - Street 1:2217 HAWKS COVE CIR
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-8497
Practice Address - Country:US
Practice Address - Phone:609-972-6988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19806400163W00000X
FL11022868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse