Provider Demographics
NPI:1477364073
Name:ANTONIO, EDGARDO RAMOS JR (LVN)
Entity type:Individual
Prefix:
First Name:EDGARDO
Middle Name:RAMOS
Last Name:ANTONIO
Suffix:JR
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68605 CORRAL RD APT 29E
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-4156
Mailing Address - Country:US
Mailing Address - Phone:760-880-7927
Mailing Address - Fax:
Practice Address - Street 1:68605 CORRAL RD APT 29E
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-4156
Practice Address - Country:US
Practice Address - Phone:760-880-7927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist