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Contact Information

RICARDO A REVILLA, MD
145 COUNTRY CLUB DR W
DESTIN, FL32541-4437
 Phone: 305-333-8436
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for RICARDO A REVILLA · (Male)

NPI Number 1326255142
Status Active
Credentials MD
Entity Individual
Enumeration date 05/17/2007
Last updated 05/04/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # ME106166
  • AR Other 5N986 BLUE SHIELD
Hospital affiliation(s)
  • CORAL GABLES HOSPITAL - (Acute Care)
    3100 DOUGLAS RD
    CORAL GABLES, FL 33134
  • LAKE CITY MEDICAL CENTER - (Acute Care)
    340 NW COMMERCE DR
    LAKE CITY, FL 32055
  • UNIVERSITY HOSPITAL AND MEDICAL CENTER - (Acute Care)
    7201 N UNIVERSITY DR
    TAMARAC, FL 33321
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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