Healthcare Provider Details

I. General information

NPI: 1861613762
Provider Name (Legal Business Name): JESUS M. RAMIREZ, MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 MARTIN LUTHER KING JR BLVD
PANAMA CITY FL
32401-3642
US

IV. Provider business mailing address

621 MARTIN LUTHER KING JR BLVD
PANAMA CITY FL
32401-3642
US

V. Phone/Fax

Practice location:
  • Phone: 850-785-3212
  • Fax: 850-785-3299
Mailing address:
  • Phone: 850-785-3212
  • Fax: 850-785-3299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0076412
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JESUS MARIA RAMIREZ I
Title or Position: PRESIDENT
Credential: M.D.
Phone: 850-785-3212