Provider Demographics
NPI:1780559468
Name:VEGA MURILLO, RICARDO SR (APRN)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:VEGA MURILLO
Suffix:SR
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 W 60TH ST APT F106
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6835
Mailing Address - Country:US
Mailing Address - Phone:786-769-0180
Mailing Address - Fax:
Practice Address - Street 1:3650 NW 82ND AVE STE 208
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6682
Practice Address - Country:US
Practice Address - Phone:305-677-9267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039755207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine