Provider Demographics
NPI:1255526059
Name:AGUIRRE ALVARADO, RICARDO FERNANDO (MD)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:FERNANDO
Last Name:AGUIRRE ALVARADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 S FEDERAL HWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6048
Mailing Address - Country:US
Mailing Address - Phone:561-733-3392
Mailing Address - Fax:561-733-8395
Practice Address - Street 1:1200 S FEDERAL HWY
Practice Address - Street 2:SUITE 207
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6048
Practice Address - Country:US
Practice Address - Phone:561-733-3392
Practice Address - Fax:561-733-8395
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100546207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAO 515ZOtherMEDICARE
FL000388700Medicaid