Provider Demographics
NPI:1043848963
Name:RAMIREZ, BRENDA NATHALI (MD)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:NATHALI
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14690 SPRING HILL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-799-0046
Mailing Address - Fax:352-799-0042
Practice Address - Street 1:4301 LAMSON AVE
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-3323
Practice Address - Country:US
Practice Address - Phone:352-691-5070
Practice Address - Fax:352-691-5075
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME160534207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program