Provider Demographics
NPI:1356424394
Name:RAMUDO-TOWNSEND, ILEANA (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:ILEANA
Middle Name:
Last Name:RAMUDO-TOWNSEND
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 COW PEN RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-6602
Mailing Address - Country:US
Mailing Address - Phone:786-507-1303
Mailing Address - Fax:786-507-1477
Practice Address - Street 1:6500 COW PEN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6602
Practice Address - Country:US
Practice Address - Phone:786-507-1303
Practice Address - Fax:786-507-1477
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN153431223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics