Healthcare Provider Details

I. General information

NPI: 1477221281
Provider Name (Legal Business Name): JESUS E RAMOS APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2021
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2190 NW 2ND ST
MIAMI FL
33125-5326
US

IV. Provider business mailing address

2190 NW 2ND ST
MIAMI FL
33125-5326
US

V. Phone/Fax

Practice location:
  • Phone: 239-250-9411
  • Fax: 239-234-6483
Mailing address:
  • Phone: 239-250-9411
  • Fax: 239-234-6483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11010451
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number110104561
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: