Provider Demographics
NPI:1124870084
Name:SALOMON, RICARDO ARMANDO
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:ARMANDO
Last Name:SALOMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12040 SW 268TH ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8160
Mailing Address - Country:US
Mailing Address - Phone:786-663-0450
Mailing Address - Fax:
Practice Address - Street 1:12040 SW 268TH ST UNIT 1
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8160
Practice Address - Country:US
Practice Address - Phone:786-663-0450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician