Provider Demographics
NPI:1134659543
Name:RAMIREZ GONZALEZ, CARMEN D (DMD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:D
Last Name:RAMIREZ GONZALEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5625 NW 109TH AVE APT 60
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3983
Mailing Address - Country:US
Mailing Address - Phone:973-536-5509
Mailing Address - Fax:
Practice Address - Street 1:8370 W FLAGLER ST STE 150
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2048
Practice Address - Country:US
Practice Address - Phone:305-227-3083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN225521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice