Provider Demographics
NPI:1558190793
Name:RAMOS, IVAN M (SRNA)
Entity type:Individual
Prefix:
First Name:IVAN
Middle Name:M
Last Name:RAMOS
Suffix:
Gender:M
Credentials:SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14555 MADISON AVE APT 606
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4364
Mailing Address - Country:US
Mailing Address - Phone:330-261-6927
Mailing Address - Fax:
Practice Address - Street 1:10900 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1712
Practice Address - Country:US
Practice Address - Phone:216-368-6459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.441190163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine