=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891001962
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAMIRO NIEVES MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/26/2010
-----------------------------------------------------
Last Update Date | 08/26/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8200 SW 117TH AVE SUITE 104
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33183-3856
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-403-0131
-----------------------------------------------------
Fax | 305-403-0767
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8200 SW 117TH AVE SUITE 104
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33183-3856
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-403-0131
-----------------------------------------------------
Fax | 305-403-0767
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MRS. LAURA CLARA-CONTRERAS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-403-0131
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | ME82256
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------