Provider Demographics
NPI:1336326040
Name:RAMON MOREDA MD PA
Entity Type:Organization
Organization Name:RAMON MOREDA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-442-1031
Mailing Address - Street 1:PO BOX 141219
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-1219
Mailing Address - Country:US
Mailing Address - Phone:305-442-1031
Mailing Address - Fax:305-448-6254
Practice Address - Street 1:760 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 113
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2076
Practice Address - Country:US
Practice Address - Phone:305-442-1031
Practice Address - Fax:305-448-6254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0051850207RR0500X
FLME51850207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE91542Medicare UPIN