Provider Demographics
NPI:1760099071
Name:RAMOS-HECKMAN, LAURA ALEXANDRA (PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ALEXANDRA
Last Name:RAMOS-HECKMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 CAPISTRANO DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-3091
Mailing Address - Country:US
Mailing Address - Phone:727-364-8390
Mailing Address - Fax:
Practice Address - Street 1:2014 CAPISTRANO DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-3091
Practice Address - Country:US
Practice Address - Phone:727-364-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9113571363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant