Provider Demographics
NPI:1740356864
Name:FERTIL, RICARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RICARD
Middle Name:
Last Name:FERTIL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12720 NE MIAMI CT
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4539
Mailing Address - Country:US
Mailing Address - Phone:786-390-1833
Mailing Address - Fax:
Practice Address - Street 1:2170 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3425
Practice Address - Country:US
Practice Address - Phone:305-631-8330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist