Provider Demographics
NPI:1639434988
Name:RAMIZ, MARTIN ANTHONY
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:ANTHONY
Last Name:RAMIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 RIDGECREST RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6343
Mailing Address - Country:US
Mailing Address - Phone:407-451-6006
Mailing Address - Fax:
Practice Address - Street 1:1022 RIDGECREST RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6343
Practice Address - Country:US
Practice Address - Phone:407-451-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL32902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer