Provider Demographics
NPI:1003671652
Name:AVISO, RAMON (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:AVISO
Suffix:
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 RIDGE HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-8213
Mailing Address - Country:US
Mailing Address - Phone:813-638-7735
Mailing Address - Fax:
Practice Address - Street 1:2814 RIDGE HOLLOW LN
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-8213
Practice Address - Country:US
Practice Address - Phone:813-638-7735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028188363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily