Provider Demographics
NPI:1235101486
Name:RAMOS, LUIS GERMAN (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:GERMAN
Last Name:RAMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 SANTA BARBARA BLVD
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-6827
Mailing Address - Country:US
Mailing Address - Phone:352-259-2159
Mailing Address - Fax:352-674-4386
Practice Address - Street 1:13696 N US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-6814
Practice Address - Country:US
Practice Address - Phone:352-508-1502
Practice Address - Fax:352-674-4386
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL182441207RR0500X
TXL9863207RR0500X
FLME78186207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167720502Medicaid
FLE5573TOtherMEDICARE PTAN
TXH37556Medicare UPIN
TXTXB126628Medicare PIN