Healthcare Provider Details

I. General information

NPI: 1184104606
Provider Name (Legal Business Name): WALTER ALFREDO RAMOS PT, CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 06/26/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 CEDAR CIR
BOYNTON BEACH FL
33436-9117
US

IV. Provider business mailing address

49 CEDAR CIR
BOYNTON BEACH FL
33436
US

V. Phone/Fax

Practice location:
  • Phone: 954-804-8025
  • Fax:
Mailing address:
  • Phone: 954-804-8025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberPOR160
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT17641
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: