Provider Demographics
NPI:1750749727
Name:RAMIREZ, RAQUEL (APRN)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:RAQUEL
Other - Middle Name:
Other - Last Name:ROQUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1 TAM O SHANTER LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-3904
Mailing Address - Country:US
Mailing Address - Phone:305-484-1115
Mailing Address - Fax:
Practice Address - Street 1:5059 SW 135TH AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027
Practice Address - Country:US
Practice Address - Phone:305-484-1115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-05
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9288956363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily