Provider Demographics
NPI:1285873620
Name:WALTER RAMIREZ MD PA
Entity type:Organization
Organization Name:WALTER RAMIREZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:O
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-559-9860
Mailing Address - Street 1:11760 BIRD RD
Mailing Address - Street 2:SUITE 622A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3582
Mailing Address - Country:US
Mailing Address - Phone:305-559-9860
Mailing Address - Fax:305-559-9207
Practice Address - Street 1:11760 BIRD RD
Practice Address - Street 2:SUITE 622A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:305-559-9860
Practice Address - Fax:305-559-9207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82563207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266285000Medicaid
FLE6353AOtherMEDICARE PTAN NUMBER
FLE6353AOtherMEDICARE PTAN NUMBER