Provider Demographics
NPI:1225521073
Name:SHIRES, RAMONA (ND)
Entity Type:Individual
Prefix:DR
First Name:RAMONA
Middle Name:
Last Name:SHIRES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5560 HIBISCUS RD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-4732
Mailing Address - Country:US
Mailing Address - Phone:850-739-1000
Mailing Address - Fax:
Practice Address - Street 1:5560 HIBISCUS RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-4732
Practice Address - Country:US
Practice Address - Phone:850-739-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X, 175L00000X
FLND9613133N00000X, 133V00000X
VT099.0134091175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No174H00000XOther Service ProvidersHealth Educator
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No175L00000XOther Service ProvidersHomeopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT099.0134091OtherNATUROPATHIC PHYSICIAN
FLND9381OtherLICENSED DIETITIAN NUTRITIONIST