MEDICARE: LUIS RAMIREZ

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	183500000X	Pharmacist	PS56002	FL

General Provider Information

NPI Number	:	1437684537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS RAMIREZ

Provider Business Mailing Address
First Line	:	2837 PIERCE ST APT 17
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-3869
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3304 BONITA BEACH RD
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-4174
Country	:	US
Telephone Number	:	239-495-1700
Fax Number	:

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

Provider Enumeration Date	:	04/26/2017
Last Update Date	:	04/26/2017

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Directions to “ LUIS RAMIREZ ” Practice Location

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