Healthcare Provider Details

I. General information

NPI: 1669392692
Provider Name (Legal Business Name): NICOLE ANDREA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11200 SW 8TH ST
MIAMI FL
33199-2516
US

IV. Provider business mailing address

15091 SW 136TH PL
MIAMI FL
33186-7647
US

V. Phone/Fax

Practice location:
  • Phone: 305-348-2000
  • Fax:
Mailing address:
  • Phone: 305-431-6017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: