Provider Demographics
NPI:1851492169
Name:DRS RICKOFF AND RICKOFF
Entity Type:Organization
Organization Name:DRS RICKOFF AND RICKOFF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ELLIOT
Authorized Official - Last Name:RICKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:850-433-5488
Mailing Address - Street 1:2110 N PALAFOX ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-1783
Mailing Address - Country:US
Mailing Address - Phone:850-433-5488
Mailing Address - Fax:850-434-9086
Practice Address - Street 1:2110 N PALAFOX ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1783
Practice Address - Country:US
Practice Address - Phone:850-433-5488
Practice Address - Fax:850-434-9086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1096213E00000X
FLPO199213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL77156Medicare ID - Type Unspecified