MEDICARE: DR. MAURICE ANTHONY RAMIREZ D.O. PH.D.

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	207P00000X	Emergency Medicine Physician	OS-06366	FL
2	207P00000X	Emergency Medicine Physician	OS6366	FL
3	207Q00000X	Family Medicine Physician	OS-6366	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	:	1457380974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAURICE ANTHONY RAMIREZ D.O. PH.D.

Provider Business Mailing Address
First Line	:	4800 BEN HILL TRAIL
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33898
Country	:	US
Telephone Number	:	407-301-3458
Fax Number	:	407-348-2686

Provider Business Practice Location Address
First Line	:	4800 BEN HILL TRAIL
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33898
Country	:	US
Telephone Number	:	407-301-3458
Fax Number	:	407-348-2686

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	07/21/2022

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