Provider Demographics
NPI:1295096451
Name:MATEO, RICARDO LUIS (RRT)
Entity type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:LUIS
Last Name:MATEO
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7816 HARBOR BEND CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8618
Mailing Address - Country:US
Mailing Address - Phone:321-228-7789
Mailing Address - Fax:
Practice Address - Street 1:7816 HARBOR BEND CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8618
Practice Address - Country:US
Practice Address - Phone:321-228-7789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT7158227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered