Provider Demographics
NPI:1912639097
Name:PINTO-FUENTES, RAMON (APRN)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:PINTO-FUENTES
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 S CONGRESS AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2128
Mailing Address - Country:US
Mailing Address - Phone:866-961-1744
Mailing Address - Fax:855-270-3240
Practice Address - Street 1:1620 S CONGRESS AVE STE 201
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2128
Practice Address - Country:US
Practice Address - Phone:866-961-1744
Practice Address - Fax:855-270-3240
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020489363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner