Healthcare Provider Details

I. General information

NPI: 1003194549
Provider Name (Legal Business Name): JUAN C RAMOS-CANSECO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2011
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 45TH ST
WEST PALM BEACH FL
33407-2413
US

IV. Provider business mailing address

901 45TH ST
WEST PALM BEACH FL
33407-2413
US

V. Phone/Fax

Practice location:
  • Phone: 561-882-6214
  • Fax: 561-882-6216
Mailing address:
  • Phone: 561-882-6214
  • Fax: 561-882-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number28375
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number13455
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberME132375
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberME132375
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number2020038636
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: