Healthcare Provider Details

I. General information

NPI: 1851491468
Provider Name (Legal Business Name): RAMIRO GARZON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 12/03/2022
Certification Date: 12/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 CIRCLE OF HOPE DR # 4126
SALT LAKE CITY UT
84112-5500
US

IV. Provider business mailing address

2000 CIRCLE OF HOPE DR # 4126
SALT LAKE CITY UT
84112-5550
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35.088651
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number35088651
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: