Healthcare Provider Details

I. General information

NPI: 1235543562
Provider Name (Legal Business Name): OLMEDO RAMILO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 NE 41ST ST
POMPANO BEACH FL
33064-4378
US

IV. Provider business mailing address

580 NE 41ST ST
POMPANO BEACH FL
33064-4378
US

V. Phone/Fax

Practice location:
  • Phone: 561-503-7584
  • Fax: 954-531-6259
Mailing address:
  • Phone: 561-503-7584
  • Fax: 954-531-6259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNY

VIII. Authorized Official

Name: OLMEDO RAMILO
Title or Position: OWNER
Credential:
Phone: 561-503-7584