Provider Demographics
NPI:1699789321
Name:RAMIREZ, EDUARDO RAUL (CHIROPRACTIC PHYSICI)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:RAUL
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:CHIROPRACTIC PHYSICI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 BLANDING BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-7724
Mailing Address - Country:US
Mailing Address - Phone:305-910-7237
Mailing Address - Fax:904-276-2521
Practice Address - Street 1:784 BLANDING BLVD STE 106
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-7724
Practice Address - Country:US
Practice Address - Phone:305-910-7237
Practice Address - Fax:904-276-2521
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381213800Medicaid
U77074Medicare UPIN
FL00055860Medicare PIN