Healthcare Provider Details

I. General information

NPI: 1184540635
Provider Name (Legal Business Name): RAMOS APRN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 NW 67TH AVE STE 308
MIAMI LAKES FL
33014-2176
US

IV. Provider business mailing address

15600 NW 67TH AVE STE 308
MIAMI LAKES FL
33014-2176
US

V. Phone/Fax

Practice location:
  • Phone: 806-724-8513
  • Fax: 424-484-3837
Mailing address:
  • Phone: 806-724-8513
  • Fax: 424-484-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YITSSY RAMOS POLO
Title or Position: PRESIDENT
Credential: APRN
Phone: 806-724-8513