| Angel Ernesto Rico Md Pa | |
|
15495 Eagle Nest Ln Suite # 225 Miami Lakes FL 33014-2266 | |
| (305) 828-3214 | |
| (305) 828-3216 |
| Full Name | Angel Ernesto Rico Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 15495 Eagle Nest Ln, Miami Lakes, Florida |
| Authorized Official Name and Position | Angel Ernesto Rico (PRESIDENT) |
| Authorized Official Contact | 3058283214 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Ernesto Rico Md Pa 15495 Eagle Nest Ln Suite # 225 Miami Lakes FL 33014-2266 Ph: (305) 828-3214 | Angel Ernesto Rico Md Pa 15495 Eagle Nest Ln Suite # 225 Miami Lakes FL 33014-2266 Ph: (305) 828-3214 |
| NPI Number | 1740557800 |
|---|---|
| Provider Enumeration Date | 11/17/2011 |
| Last Update Date | 11/17/2011 |
| Medicare PECOS PAC ID | 9133389968 |
|---|---|
| Medicare Enrollment ID | O20120402000092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740557800 | NPI | - | NPPES |
| 1417166091 | Other | FL | IND NPI |
| 278704100 | Medicaid | FL | |
| ME98769 | Other | FL | FL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME98769 (Florida) | Primary |
| Provider Name | Angel E Rico |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1417166091 PECOS PAC ID: 3072601624 Enrollment ID: I20071114000422 |
| Provider Name | Marbelys Esquijarosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275028698 PECOS PAC ID: 8820413396 Enrollment ID: I20200730002242 |
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