Provider Demographics
NPI:1619164829
Name:ALFREDO C. RAMIREZ, MD PLLC
Entity Type:Organization
Organization Name:ALFREDO C. RAMIREZ, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:C
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-663-0688
Mailing Address - Street 1:P.O. BOX 15399
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85708
Mailing Address - Country:US
Mailing Address - Phone:520-663-0689
Mailing Address - Fax:520-663-0690
Practice Address - Street 1:8684 E SEMPLE STREET
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747
Practice Address - Country:US
Practice Address - Phone:520-663-0688
Practice Address - Fax:520-663-0690
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALFREDO C RAMIREZ MD PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-02
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ126942084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ75168Medicare PIN