Provider Demographics
NPI:1598813743
Name:UGARTE, RAMON JR (PA-C)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:UGARTE
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:5060 N 19TH AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-3212
Mailing Address - Country:US
Mailing Address - Phone:480-788-5621
Mailing Address - Fax:480-779-1277
Practice Address - Street 1:5060 N 19TH AVE STE 207
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3212
Practice Address - Country:US
Practice Address - Phone:480-788-5621
Practice Address - Fax:480-779-1277
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2020-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ1056363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical