Healthcare Provider Details

I. General information

NPI: 1720096647
Provider Name (Legal Business Name): PEARL S HUANG-RAMIREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 KEVSTIN DR
KISSIMMEE FL
34744-5843
US

IV. Provider business mailing address

1600 BUDINGER AVE STE D
SAINT CLOUD FL
34769-6005
US

V. Phone/Fax

Practice location:
  • Phone: 321-442-1214
  • Fax: 321-442-1215
Mailing address:
  • Phone: 407-892-3387
  • Fax: 407-892-7297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME83477
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: