| Javier Ricardo Md Pa | |
|
7000 W 12th Ave Ste 12 Hialeah FL 33014-5154 | |
| (305) 267-6774 | |
| (305) 267-8482 |
| Full Name | Javier Ricardo Md Pa |
|---|---|
| Speciality | General Practice |
| Location | 7000 W 12th Ave Ste 12, Hialeah, Florida |
| Authorized Official Name and Position | Javier Ricardo (PRESIDENT) |
| Authorized Official Contact | 3053027257 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Javier Ricardo Md Pa 7000 W 12th Ave Ste 12 Hialeah FL 33014-5154 Ph: (305) 267-6774 | Javier Ricardo Md Pa 7000 W 12th Ave Ste 12 Hialeah FL 33014-5154 Ph: (305) 267-6774 |
| NPI Number | 1255355665 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 04/23/2024 |
| Medicare PECOS PAC ID | 4284669011 |
|---|---|
| Medicare Enrollment ID | O20051017001023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255355665 | NPI | - | NPPES |
| 273137100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ME92030 (Florida) | Primary |
| Provider Name | Javier Ricardo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1770536690 PECOS PAC ID: 8921033754 Enrollment ID: I20051020000809 |
| Provider Name | Nery Avila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649650532 PECOS PAC ID: 4880044627 Enrollment ID: I20231220001802 |
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