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General NPI Number Information
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NPI Number | 1205583093
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Entity Type | Individual
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Provider Name | CARLOS EDUARDO RAMOS MARTINEZ
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Gender | Male
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Dates
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Enumeration Date | 03/02/2022
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 2460 TAMIAMI TRL STE A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-3922
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Country | US
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Telephone | 855-674-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 7908 SPRING VALLEY DR
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City | TAMPA
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State | FL
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Zip | 33615-2117
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Country | US
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Telephone | 813-802-0468
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN1101840
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License Number State | FL
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