Healthcare Provider Details

I. General information

NPI: 1861793192
Provider Name (Legal Business Name): LEILANIE PEREZ RAMIREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 11/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD BOX 100296
GAINESVILLE FL
32610-0296
US

IV. Provider business mailing address

1600 SW ARCHER RD BOX 100296
GAINESVILLE FL
32610-0296
US

V. Phone/Fax

Practice location:
  • Phone: 352-294-5252
  • Fax:
Mailing address:
  • Phone: 352-294-5252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number12698
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME129301
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME129301
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: