Provider Demographics
NPI:1174059752
Name:RICARD, JENIFFER
Entity type:Individual
Prefix:
First Name:JENIFFER
Middle Name:
Last Name:RICARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 SW 129TH PL
Mailing Address - Street 2:109
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2187
Mailing Address - Country:US
Mailing Address - Phone:786-515-8050
Mailing Address - Fax:
Practice Address - Street 1:840 SW 129TH PL
Practice Address - Street 2:109
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-2187
Practice Address - Country:US
Practice Address - Phone:786-515-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9582983163WA2000X
FLTT14821227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified