Provider Demographics
NPI:1174873244
Name:LUIS G RAMIREZ M D P A
Entity type:Organization
Organization Name:LUIS G RAMIREZ M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:GUILLERMO
Authorized Official - Last Name:RAMIREZ BRACHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-403-0131
Mailing Address - Street 1:8200 SOUTHWEST 117 AVENUE
Mailing Address - Street 2:SUITE 104-A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4825
Mailing Address - Country:US
Mailing Address - Phone:305-403-0131
Mailing Address - Fax:305-403-0767
Practice Address - Street 1:8200 SOUTHWEST 117 AVENUE
Practice Address - Street 2:SUITE 104-A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4825
Practice Address - Country:US
Practice Address - Phone:305-403-0131
Practice Address - Fax:305-403-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107667207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty