Healthcare Provider Details

I. General information

NPI: 1134809213
Provider Name (Legal Business Name): DESMOND MARTEZ ANTONIO RAMIREZ-BRANCH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/24/2023
Certification Date: 07/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7648 CLOVERNOOK AVE
CINCINNATI OH
45231-3506
US

IV. Provider business mailing address

7648 CLOVERNOOK AVE
CINCINNATI OH
45231-3506
US

V. Phone/Fax

Practice location:
  • Phone: 513-713-6544
  • Fax:
Mailing address:
  • Phone: 513-713-6544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: