Provider Demographics
NPI:1144629205
Name:RIZK, RALPH (DO)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:
Last Name:RIZK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 RIVERSIDE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4148
Mailing Address - Country:US
Mailing Address - Phone:904-328-5979
Mailing Address - Fax:904-619-9925
Practice Address - Street 1:1045 RIVERSIDE AVE STE 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4148
Practice Address - Country:US
Practice Address - Phone:904-328-5979
Practice Address - Fax:904-619-9925
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14887207X00000X
PAOS020026207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS14887OtherMEDICAL LICENSE NUMBER