Provider Demographics
NPI:1720804834
Name:RAMIREZ, ROBERTO P (PA)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:P
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5027 SPRING RUN AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-3334
Mailing Address - Country:US
Mailing Address - Phone:787-661-0007
Mailing Address - Fax:
Practice Address - Street 1:5027 SPRING RUN AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-3334
Practice Address - Country:US
Practice Address - Phone:787-661-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-23
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR753-PA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical