MEDICARE: RAMON PEDRO DIZON M.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	207R00000X	Internal Medicine Physician	ME93424	FL
2	207RI0200X	Infectious Disease Physician	ME93424	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	:	1619940715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMON PEDRO DIZON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 746638
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6638
Country	:	US
Telephone Number	:	904-202-1032
Fax Number	:	904-376-4107

Provider Business Practice Location Address
First Line	:	820 PRUDENTIAL DR STE 515
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-8207
Country	:	US
Telephone Number	:	904-396-4886
Fax Number	:	904-390-7487

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	06/20/2024

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Directions to “ RAMON PEDRO DIZON M.D.” Practice Location

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