Provider Demographics
NPI:1568710473
Name:ECHAGUE COLMAN, RAMON ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:ANTONIO
Last Name:ECHAGUE COLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 W STATE ROAD 434 STE 203
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-5162
Mailing Address - Country:US
Mailing Address - Phone:407-265-7775
Mailing Address - Fax:407-266-2266
Practice Address - Street 1:515 W STATE ROAD 434 STE 203
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5162
Practice Address - Country:US
Practice Address - Phone:407-265-7775
Practice Address - Fax:407-266-2266
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP657207RP1001X
FLME111476207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014666200Medicaid
FL014666200Medicaid