Provider Demographics
NPI:1528219235
Name:RAMIREZ, TULLIE ACKERLY (MD)
Entity Type:Individual
Prefix:DR
First Name:TULLIE
Middle Name:ACKERLY
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TULLIE
Other - Middle Name:
Other - Last Name:ACKERLY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:77 W UNDERWOOD ST FL 5
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1122
Mailing Address - Country:US
Mailing Address - Phone:407-649-7400
Mailing Address - Fax:407-649-7429
Practice Address - Street 1:77 W UNDERWOOD ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1122
Practice Address - Country:US
Practice Address - Phone:407-649-7400
Practice Address - Fax:407-649-7429
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113307207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL011679600Medicaid
FL011679600Medicaid