Healthcare Provider Details

I. General information

NPI: 1376010405
Provider Name (Legal Business Name): EDWIN S RAMOS APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2018
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 W SAINT ISABEL ST STE F
TAMPA FL
33607-6371
US

IV. Provider business mailing address

2901 W SAINT ISABEL ST STE F
TAMPA FL
33607-6371
US

V. Phone/Fax

Practice location:
  • Phone: 813-935-4744
  • Fax: 813-931-1427
Mailing address:
  • Phone: 813-935-4744
  • Fax: 813-931-1427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN9398337
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: