Provider Demographics
NPI:1033645411
Name:RAMOS, XAVIER ROMEO (MD)
Entity Type:Individual
Prefix:
First Name:XAVIER
Middle Name:ROMEO
Last Name:RAMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 NE 8TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5613
Mailing Address - Country:US
Mailing Address - Phone:305-901-0585
Mailing Address - Fax:305-901-0523
Practice Address - Street 1:2804 NE 8TH ST STE 103
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5613
Practice Address - Country:US
Practice Address - Phone:305-901-0585
Practice Address - Fax:305-901-0523
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME143154207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115955000Medicaid