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General NPI Number Information
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NPI Number | 1881499861
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Entity Type | Organization
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Legal Business Name | ACCESS MEDICAL GROUP OF SAND LAKE, LLC
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 1233 WEST SAND LAKE RD STE 8
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City | ORLANDO
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State | FL
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Zip | 32809-7084
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Country | US
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Telephone | 407-232-6160
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Fax | 407-220-1975
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Provider Business Mailing Address
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Address Line | 6100 BLUE LAGOON DR STE 365
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City | MIAMI
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State | FL
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Zip | 33126-7010
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Country | US
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Telephone | 786-322-7333
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RAYNY RAMIREZ
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Credential |
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Telephone | 786-322-7333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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