Provider Demographics
NPI:1114217312
Name:RAMIREZ, RAFAEL (CRNA)
Entity Type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 SW 93RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-1746
Mailing Address - Country:US
Mailing Address - Phone:787-455-0964
Mailing Address - Fax:
Practice Address - Street 1:3512 SW 93RD AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-1746
Practice Address - Country:US
Practice Address - Phone:787-455-0964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9318131367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered