Healthcare Provider Details

I. General information

NPI: 1407632151
Provider Name (Legal Business Name): RAMIREZ SPORTS CARDIOLOGY AND ARRHYTHMIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2023
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8045 SPYGLASS HILL RD STE 105
MELBOURNE FL
32940-8567
US

IV. Provider business mailing address

PO BOX 410054
MELBOURNE FL
32941-0054
US

V. Phone/Fax

Practice location:
  • Phone: 321-462-9797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEXIES RAMIREZ
Title or Position: OWNER
Credential: MD
Phone: 321-462-9797