Provider Demographics
NPI:1770505224
Name:PRESAS, RICARDO EMILIO (MD)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:EMILIO
Last Name:PRESAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13431 SW 38TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6902
Mailing Address - Country:US
Mailing Address - Phone:305-297-0623
Mailing Address - Fax:
Practice Address - Street 1:2851 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3203
Practice Address - Country:US
Practice Address - Phone:305-298-3488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2022-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67165208D00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL90369Medicare ID - Type UnspecifiedPROVIDER
FLF90369Medicare UPIN