Provider Demographics
NPI:1063035368
Name:RAMIREZ ARTEAGA, ILLOVIS MARIA (APRN)
Entity Type:Individual
Prefix:
First Name:ILLOVIS
Middle Name:MARIA
Last Name:RAMIREZ ARTEAGA
Suffix:
Gender:F
Credentials:APRN
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6100 BLUE LAGOON DR STE 365
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-7010
Mailing Address - Country:US
Mailing Address - Phone:786-322-7333
Mailing Address - Fax:786-347-5022
Practice Address - Street 1:1490 NW 27TH AVE STE 130
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-2173
Practice Address - Country:US
Practice Address - Phone:305-635-7710
Practice Address - Fax:786-621-7817
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11006663363LF0000X
FLAPRN11006663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111478800Medicaid