Healthcare Provider Details

I. General information

NPI: 1477971992
Provider Name (Legal Business Name): FERDINAND RODRIGUEZ AGRAMONTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 06/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 CEI DR
BLUE ASH OH
45242
US

IV. Provider business mailing address

1945 CEI DR
BLUE ASH OH
45242-5664
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-5133
  • Fax: 513-569-3941
Mailing address:
  • Phone: 513-984-5133
  • Fax: 513-984-4494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35.133328
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: