Healthcare Provider Details

I. General information

NPI: 1609746577
Provider Name (Legal Business Name): AGELESS HEALTH & PAIN MANAGEMENT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4104 MILLENIA BLVD STE 111
ORLANDO FL
32839-6422
US

IV. Provider business mailing address

4104 MILLENIA BLVD STE 111
ORLANDO FL
32839-6422
US

V. Phone/Fax

Practice location:
  • Phone: 407-205-6557
  • Fax: 407-264-8890
Mailing address:
  • Phone: 407-205-6557
  • Fax: 407-264-8890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RYAN RAMOS
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 201-887-4788