Provider Demographics
NPI:1891909990
Name:RAMIREZ, LINA MARIA
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:MARIA
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7887 NW 62ND TER
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3350
Mailing Address - Country:US
Mailing Address - Phone:954-227-7837
Mailing Address - Fax:954-984-1783
Practice Address - Street 1:7887 NW 62ND TER
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-3350
Practice Address - Country:US
Practice Address - Phone:954-227-7837
Practice Address - Fax:954-984-1783
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL222Q00000XMedicaid