Provider Demographics
NPI:1770997157
Name:CAYABYAB, RICO PRADO (RN)
Entity type:Individual
Prefix:
First Name:RICO
Middle Name:PRADO
Last Name:CAYABYAB
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6927 ROSETREE PL
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-5750
Mailing Address - Country:US
Mailing Address - Phone:513-398-3459
Mailing Address - Fax:
Practice Address - Street 1:411 WESTERN ROW RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1438
Practice Address - Country:US
Practice Address - Phone:513-701-3426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.396154163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse