Provider Demographics
NPI:1851415780
Name:GARCIA TELLADO, RAMON (RAMON GARCIA TELLADO)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:GARCIA TELLADO
Suffix:
Gender:M
Credentials:RAMON GARCIA TELLADO
Other - Prefix:DR
Other - First Name:RAMON
Other - Middle Name:
Other - Last Name:GARCIA TELLADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RAMON GARCIA TELLADO
Mailing Address - Street 1:11760 SW 40TH ST
Mailing Address - Street 2:SUITE 729
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3582
Mailing Address - Country:US
Mailing Address - Phone:305-559-2779
Mailing Address - Fax:305-559-6119
Practice Address - Street 1:11760 SW 40TH ST
Practice Address - Street 2:SUITE 729
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:305-559-2779
Practice Address - Fax:305-559-6119
Is Sole Proprietor?:No
Enumeration Date:2007-03-17
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL02-123246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist