Provider Demographics
NPI:1588601686
Name:GUMUCIO, RAMIRO M (MD)
Entity Type:Individual
Prefix:
First Name:RAMIRO
Middle Name:M
Last Name:GUMUCIO
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 1:3411 INDIAN CREEK DR APT 1301
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4064
Mailing Address - Country:US
Mailing Address - Phone:305-205-3653
Mailing Address - Fax:
Practice Address - Street 1:3411 INDIAN CREEK DR APT 1301
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4064
Practice Address - Country:US
Practice Address - Phone:305-205-3653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95648174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist