Provider Demographics
NPI:1821743048
Name:RAMON A GUEVARA D.O.,P.A.
Entity Type:Organization
Organization Name:RAMON A GUEVARA D.O.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUEVARA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-549-8255
Mailing Address - Street 1:45 NW 8TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4452
Mailing Address - Country:US
Mailing Address - Phone:305-549-8255
Mailing Address - Fax:786-362-6497
Practice Address - Street 1:16650 SW 88TH ST STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1282
Practice Address - Country:US
Practice Address - Phone:305-549-8255
Practice Address - Fax:786-362-6497
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAMON A GUEVARA D.O.,P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002958902Medicaid