Provider Demographics
NPI:1790773554
Name:RAMEY, DUSTIN HARRIS (OD)
Entity Type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:HARRIS
Last Name:RAMEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2836 ENTERPRISE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-5210
Mailing Address - Country:US
Mailing Address - Phone:386-668-8885
Mailing Address - Fax:386-668-3301
Practice Address - Street 1:2836 ENTERPRISE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-5210
Practice Address - Country:US
Practice Address - Phone:386-668-8885
Practice Address - Fax:386-668-3301
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP0003199152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620364700Medicaid
FL1222680001Medicare NSC
FL620364700Medicaid
U70934Medicare UPIN
FLCI7144Medicare PIN