MEDICARE: DR. RAMON PLA VARONA JR. MD

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	207R00000X	Internal Medicine Physician	40450	IA
2	207R00000X	Internal Medicine Physician	036 079717	IL
3	207R00000X	Internal Medicine Physician	036 074432	IL
4	207R00000X	Internal Medicine Physician	35.134915	OH

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
2	35.134915	OTHER	OH	LICENSE

General Provider Information

NPI Number	:	1184715641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMON PLA VARONA JR. MD

Provider Business Mailing Address
First Line	:	30 W MONROE ST STE 1200
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60603-2420
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:	773-866-8014

Provider Business Practice Location Address
First Line	:	10688 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-5411
Country	:	US
Telephone Number	:	216-682-7703
Fax Number	:	216-236-7768

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	06/25/2019

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