Provider Demographics
NPI:1629064753
Name:RAMOS, OTTO M (MD)
Entity Type:Individual
Prefix:
First Name:OTTO
Middle Name:M
Last Name:RAMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3200 SW 60TH CT
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4000
Mailing Address - Country:US
Mailing Address - Phone:305-662-8378
Mailing Address - Fax:305-663-6829
Practice Address - Street 1:3200 SW 60TH CT
Practice Address - Street 2:SUITE 206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4000
Practice Address - Country:US
Practice Address - Phone:305-662-8378
Practice Address - Fax:305-663-6829
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 349912080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251925900Medicaid
FLD63625Medicare UPIN
FL95823Medicare ID - Type Unspecified