Provider Demographics
NPI:1770850018
Name:RAMIREZ, JOSE LIBORIO JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:LIBORIO
Last Name:RAMIREZ
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:400 RUSSELL AVE BLDG 41
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-1006
Mailing Address - Country:US
Mailing Address - Phone:504-678-7925
Mailing Address - Fax:504-678-7923
Practice Address - Street 1:400 RUSSELL AVE BLDG 41
Practice Address - Street 2:
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-1006
Practice Address - Country:US
Practice Address - Phone:504-678-7925
Practice Address - Fax:504-678-7923
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1102208363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant