Provider Demographics
NPI:1942810957
Name:PARRA RAMIREZ, MARLON RICARDO (NP)
Entity Type:Individual
Prefix:
First Name:MARLON
Middle Name:RICARDO
Last Name:PARRA RAMIREZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 NE 24TH ST APT 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-4860
Mailing Address - Country:US
Mailing Address - Phone:786-274-9441
Mailing Address - Fax:
Practice Address - Street 1:2000 NW 87TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2655
Practice Address - Country:US
Practice Address - Phone:305-718-9138
Practice Address - Fax:844-665-4827
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11008334363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily