Provider Demographics
NPI:1346483518
Name:RAMIREZ BRACHO, LUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:
Last Name:RAMIREZ BRACHO
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 1:7000 SW 62ND AVE,
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4728
Mailing Address - Country:US
Mailing Address - Phone:305-830-0551
Mailing Address - Fax:305-830-0551
Practice Address - Street 1:9035 SW 72ND ST STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3441
Practice Address - Country:US
Practice Address - Phone:305-830-0551
Practice Address - Fax:786-298-5081
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234696207X00000X
NY003783207X00000X
NYP47466207X00000X
FLME107667207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006451100Medicaid