Provider Demographics
NPI:1437385267
Name:GUADALUPE, RAMON E
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:E
Last Name:GUADALUPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 ROAD OAK SPRING DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570
Mailing Address - Country:US
Mailing Address - Phone:813-884-8877
Mailing Address - Fax:
Practice Address - Street 1:2232 ROAD OAK SPRING DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570
Practice Address - Country:US
Practice Address - Phone:813-884-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 56280225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist