Provider Demographics
NPI:1841400124
Name:RAMIREZ, MANUEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 LAKE AVE
Mailing Address - Street 2:SUITE 132
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-6424
Mailing Address - Country:US
Mailing Address - Phone:407-960-3656
Mailing Address - Fax:407-960-3657
Practice Address - Street 1:132 LAKE AVE
Practice Address - Street 2:SUITE 132
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-6424
Practice Address - Country:US
Practice Address - Phone:407-960-3656
Practice Address - Fax:407-960-3657
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22026Medicare ID - Type Unspecified