Provider Demographics
NPI:1154051563
Name:RAMOS NAVARRO, ROGER
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:
Last Name:RAMOS NAVARRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ROGER
Other - Middle Name:
Other - Last Name:RAMOS NAVARRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:11980 SW 8TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1669
Mailing Address - Country:US
Mailing Address - Phone:786-452-1922
Mailing Address - Fax:
Practice Address - Street 1:11980 SW 8TH ST STE 1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1669
Practice Address - Country:US
Practice Address - Phone:786-452-1922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist