Provider Demographics
NPI:1245943612
Name:RAMIREZ, NICOLAS ALEXANDER
Entity type:Individual
Prefix:
First Name:NICOLAS
Middle Name:ALEXANDER
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4971 SW 170TH AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33331-1256
Mailing Address - Country:US
Mailing Address - Phone:954-895-1675
Mailing Address - Fax:
Practice Address - Street 1:8059 W MCNAB RD STE 8
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-3254
Practice Address - Country:US
Practice Address - Phone:954-895-1675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4421171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist