Provider Demographics
NPI:1629369046
Name:RAMOS, ILEANA (RPH)
Entity Type:Individual
Prefix:MS
First Name:ILEANA
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E HILLSBORO BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4356
Mailing Address - Country:US
Mailing Address - Phone:954-570-5943
Mailing Address - Fax:954-570-8721
Practice Address - Street 1:1500 E HILLSBORO BLVD STE 103
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4356
Practice Address - Country:US
Practice Address - Phone:954-570-5943
Practice Address - Fax:954-570-8721
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0032478183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist