Provider Demographics
NPI:1366478232
Name:RAMIREZ, GUILLERMO L (ARNP)
Entity Type:Individual
Prefix:
First Name:GUILLERMO
Middle Name:L
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15927 SW 82ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3087
Mailing Address - Country:US
Mailing Address - Phone:786-285-8750
Mailing Address - Fax:
Practice Address - Street 1:16800 NW 2ND AVE STE 400
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33169-5501
Practice Address - Country:US
Practice Address - Phone:786-285-8750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9249119363LF0000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL763735700Medicaid