Provider Demographics
NPI:1922032341
Name:IGLESIAS, RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:IGLESIAS
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 1:3661 S MIAMI AVE
Mailing Address - Street 2:SUITE 1010
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4236
Mailing Address - Country:US
Mailing Address - Phone:305-856-5670
Mailing Address - Fax:305-856-8030
Practice Address - Street 1:3661 S MIAMI AVE
Practice Address - Street 2:SUITE 1010
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4236
Practice Address - Country:US
Practice Address - Phone:305-856-5670
Practice Address - Fax:305-856-8030
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053905207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL049084900Medicaid
FL049084900Medicaid
FL07545WMedicare PIN
FLD21239Medicare UPIN