Provider Demographics
NPI:1720661291
Name:DR. SHANNON RAMIREZ, LLC
Entity Type:Organization
Organization Name:DR. SHANNON RAMIREZ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:678-889-0881
Mailing Address - Street 1:1070 MONTGOMERY RD # 401
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7420
Mailing Address - Country:US
Mailing Address - Phone:678-889-0881
Mailing Address - Fax:
Practice Address - Street 1:831 S STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3502
Practice Address - Country:US
Practice Address - Phone:407-587-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No283X00000XHospitalsRehabilitation Hospital
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing FacilityGroup - Single Specialty