Provider Demographics
NPI:1184600637
Name:RAMIREZ, ALFONSO (MD)
Entity type:Individual
Prefix:
First Name:ALFONSO
Middle Name:
Last Name:RAMIREZ
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 1:8230 NW 191ST ST APT D
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5397
Mailing Address - Country:US
Mailing Address - Phone:305-467-3613
Mailing Address - Fax:
Practice Address - Street 1:8230 NW 191ST ST
Practice Address - Street 2:APT D
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5397
Practice Address - Country:US
Practice Address - Phone:305-467-3613
Practice Address - Fax:305-357-3875
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-16
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83873208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264256500Medicaid
FLH11914Medicare UPIN
FLE3825VMedicare PIN