Provider Demographics
NPI:1902643604
Name:RAMOS, EDWARD VICTORIANO JR (DMD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:VICTORIANO
Last Name:RAMOS
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1886 GREEN DRAGON DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-8556
Mailing Address - Country:US
Mailing Address - Phone:850-619-2512
Mailing Address - Fax:
Practice Address - Street 1:149 E 13TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4749
Practice Address - Country:US
Practice Address - Phone:407-952-0083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29340122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist