Provider Demographics
NPI:1467001677
Name:RAMIREZ, DIEGO (ATC, LAT, LMT)
Entity Type:Individual
Prefix:MR
First Name:DIEGO
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:ATC, LAT, LMT
Other - Prefix:MR
Other - First Name:DIEGO
Other - Middle Name:FERNANDO
Other - Last Name:RAMIREZ MOLINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, LAT, LMT
Mailing Address - Street 1:538 MARKLEN LOOP
Mailing Address - Street 2:
Mailing Address - City:POLK CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33868-9600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:538 MARKLEN LOOP
Practice Address - Street 2:
Practice Address - City:POLK CITY
Practice Address - State:FL
Practice Address - Zip Code:33868-9600
Practice Address - Country:US
Practice Address - Phone:828-789-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL51722255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer