Provider Demographics
NPI:1750851689
Name:RAMOS, MYRA CLEOTILDE RED (RN)
Entity Type:Individual
Prefix:MRS
First Name:MYRA CLEOTILDE
Middle Name:RED
Last Name:RAMOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2537 AMATI DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7703
Mailing Address - Country:US
Mailing Address - Phone:407-780-6893
Mailing Address - Fax:
Practice Address - Street 1:2537 AMATI DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7703
Practice Address - Country:US
Practice Address - Phone:407-780-6893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9383027163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice