Medina, Ricardo

Medina, Ricardo is an sole proprietor health care provider with primary practice located at 111 S Treaty Rd , Miami OK 74354-5327. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Medina, Ricardo can be contacted via phone (918) 540-1522.

Contact Information

Primary practice address
111 S Treaty Rd Miami OK 74354-5327
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1629526355
LBN Legal business name Medina, Ricardo
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 11th, 2016
Last updated Sep 14th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629526355 NPPES
Texas Other S202187064 DRIVERS LICENSE

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