Provider Demographics
NPI:1700849031
Name:RAMIREZ, JORGE ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:ALBERTO
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JORGE
Other - Middle Name:ALBERTO
Other - Last Name:RAMIREZ-GONZALEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7600W TIDWELL RD 103
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-5719
Mailing Address - Country:US
Mailing Address - Phone:713-461-3573
Mailing Address - Fax:
Practice Address - Street 1:841 OCEANSIDE DR
Practice Address - Street 2:
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-1749
Practice Address - Country:US
Practice Address - Phone:208-415-0595
Practice Address - Fax:208-763-3644
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-08
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM91142085R0202X
FLME802132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology