| Doctor Name: | DR. ANGEL ERNESTO RICO |
| NPI Number: | 1417166091 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | ME 98769 |
| Business Practice Address: | 15495 Eagle Nest Ln Suite 225 Miami Lakes, FL - 330142266 |
| Business Phone Number: | 3058283214 |
| Business Fax Number: | 3058283216 |
| Mailing Address: | 15495 Eagle Nest Ln, Suite 225 MIAMI LAKES |
| State: | FL |
| Postal Code: | 330142266 |
| Phone Number: | 3058283214 |
| Fax Number: | 3058283216 |
| NPI Enumeration Date: | 05/21/2007 |
| NPI Last Update Date: | 09/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME 98769 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |