Provider Demographics
NPI:1255020749
Name:RAMIREZ SOLIS, LUIS FERNANDO
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:FERNANDO
Last Name:RAMIREZ SOLIS
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 1:1266 EVERGREEN AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-2303
Mailing Address - Country:US
Mailing Address - Phone:917-474-1371
Mailing Address - Fax:
Practice Address - Street 1:1266 EVERGREEN AVE FL 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-2303
Practice Address - Country:US
Practice Address - Phone:917-474-1371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker