Provider Demographics
NPI:1225344401
Name:RESOP, RAMONE DALANE (SFIDC)
Entity Type:Individual
Prefix:MR
First Name:RAMONE
Middle Name:DALANE
Last Name:RESOP
Suffix:
Gender:M
Credentials:SFIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10234 CREST RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-2617
Mailing Address - Country:US
Mailing Address - Phone:850-384-7849
Mailing Address - Fax:
Practice Address - Street 1:MCM CREW FEARLESS
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:92101
Practice Address - Country:US
Practice Address - Phone:850-384-7849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman