MEDICARE: RAMIRO M GUMUCIO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME95648	FL

General Provider Information

NPI Number	:	1588601686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMIRO M GUMUCIO M.D.

Provider Business Mailing Address
First Line	:	3411 INDIAN CREEK DR APT 1301
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-4064
Country	:	US
Telephone Number	:	305-205-3653
Fax Number	:

Provider Business Practice Location Address
First Line	:	3411 INDIAN CREEK DR APT 1301
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-4064
Country	:	US
Telephone Number	:	305-205-3653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	02/15/2011

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