Provider Demographics
NPI:1801855994
Name:OLAZAGASTI LEDEE, RAMSIS FELIPE (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMSIS
Middle Name:FELIPE
Last Name:OLAZAGASTI LEDEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 CHENEY HWY
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-6700
Mailing Address - Country:US
Mailing Address - Phone:321-269-9800
Mailing Address - Fax:321-269-7082
Practice Address - Street 1:2185 CHENEY HWY
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-6700
Practice Address - Country:US
Practice Address - Phone:321-269-9800
Practice Address - Fax:321-269-7082
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1136208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBO8043957OtherDEA
PRI11257Medicare UPIN
PR22133Medicare ID - Type Unspecified