Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | ME110485 | FL |
N | 2081S0010X | Sports Medicine | ME110485 | FL |
N | 213ES0000X | Sports Medicine | ME110485 | FL |
NPI | 1114172673 |
---|---|
Provider Name | Dr. Ricardo J Vasquez-Duarte |
First Address | Hialeah, FL 33013-3849 |
Second Address | Hialeah, FL 33013-3825 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2008 |
Last Update Date | 16/07/2020 |