Provider Demographics
NPI:1114302619
Name:RAMIREZ, EVELYN LYDIA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:LYDIA
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:EVELYN
Other - Middle Name:LYDIA
Other - Last Name:VELEZ SANTIAGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1461 CHESSINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1920
Mailing Address - Country:US
Mailing Address - Phone:407-732-4251
Mailing Address - Fax:
Practice Address - Street 1:100 TECHNOLOGY PARK
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-6297
Practice Address - Country:US
Practice Address - Phone:877-296-3177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-25
Last Update Date:2015-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS27746183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist