Provider Demographics
NPI:1902144876
Name:RALPH M VICARI MD LLC
Entity Type:Organization
Organization Name:RALPH M VICARI MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:VICARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-917-7301
Mailing Address - Street 1:1437 PINEAPPLE AVE APT 802
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-6591
Mailing Address - Country:US
Mailing Address - Phone:321-917-7301
Mailing Address - Fax:
Practice Address - Street 1:1437 PINEAPPLE AVE APT 802
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-6591
Practice Address - Country:US
Practice Address - Phone:321-917-7301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty