Healthcare Provider Details
I. General information
NPI: 1174873244
Provider Name (Legal Business Name): LUIS G RAMIREZ M D P A
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2012
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9035 SW 72ND ST STE 104
MIAMI FL
33173-3441
US
IV. Provider business mailing address
9035 SW 72ND ST STE 104
MIAMI FL
33173-3441
US
V. Phone/Fax
- Phone: 305-830-0551
- Fax: 786-298-5081
- Phone: 305-830-0551
- Fax: 786-298-5081
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | ME107667 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0005X |
| Taxonomy | Sports Medicine (Orthopaedic Surgery) Physician |
| License Number | ME107667 |
| License Number State | FL |
VIII. Authorized Official
Name:
LUIS
G
RAMIREZ BRACHO
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 917-216-7759