MEDICARE: LIBERTAD A RAMOS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	9397861	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134690712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIBERTAD A RAMOS NP

Provider Business Mailing Address
First Line	:	5827 CORPORATE WAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2000
Country	:	US
Telephone Number	:	561-844-9443
Fax Number	:	561-472-9692

Provider Business Practice Location Address
First Line	:	3235 SW PORT ST LUCIE BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34953-3405
Country	:	US
Telephone Number	:	772-408-5063
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2018
Last Update Date	:	10/28/2019

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Directions to “ LIBERTAD A RAMOS NP” Practice Location

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