Provider Demographics
NPI:1396022273
Name:ALFONSO RAMIREZ MD PA
Entity Type:Organization
Organization Name:ALFONSO RAMIREZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-467-3613
Mailing Address - Street 1:8230 NW 191ST ST
Mailing Address - Street 2:APT D
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5397
Mailing Address - Country:US
Mailing Address - Phone:305-467-3613
Mailing Address - Fax:305-357-3875
Practice Address - Street 1:1255 W 46TH ST STE 7A
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3257
Practice Address - Country:US
Practice Address - Phone:305-467-3613
Practice Address - Fax:305-357-3875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264256500Medicaid
FL264256500Medicaid