Mary Joyce Rico, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

LL-909 Issued in FL

Practice address

1432 NE 105TH St
Miami Shores, FL 33138-2114

Phone

(224) 216-7749

Fax

(847) 835-9946

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1245338342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1432 NE 105TH ST",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382114",
            "telephone_number": "224-216-7749",
            "fax_number": "847-835-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 NE 105TH ST",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382114",
            "telephone_number": "224-216-7749",
            "fax_number": "847-835-9946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICO",
        "first_name": "MARY",
        "middle_name": "JOYCE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "13878",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "30465",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "LL-909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Miami Shores, FL
• Providers in Miami Shores, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.