Healthcare Provider Details

I. General information

NPI: 1205808771
Provider Name (Legal Business Name): JORGE A. RAMIREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 03/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 W MILLER ST 8TH FLOOR
ORLANDO FL
32806-2032
US

IV. Provider business mailing address

92 W MILLER ST 8TH FLOOR
ORLANDO FL
32806-2032
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-7970
  • Fax: 321-841-7978
Mailing address:
  • Phone: 321-841-7970
  • Fax: 321-841-7978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME55906
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberME55906
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: