Provider Demographics
NPI:1164203865
Name:RAMOS RODRIGUEZ, JORGE A
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:A
Last Name:RAMOS RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19611 NW 37TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-1951
Mailing Address - Country:US
Mailing Address - Phone:229-327-0774
Mailing Address - Fax:
Practice Address - Street 1:8626 NOROAD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-6218
Practice Address - Country:US
Practice Address - Phone:904-236-9690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker