Provider Demographics
NPI:1255566378
Name:VIRAMONTES, RONALD RAY JR (NREMT-P, IDMT)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:RAY
Last Name:VIRAMONTES
Suffix:JR
Gender:M
Credentials:NREMT-P, IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MALVESTI STREET
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-0001
Mailing Address - Country:US
Mailing Address - Phone:910-243-3315
Mailing Address - Fax:
Practice Address - Street 1:1 MALVESTI STREET
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-3430
Practice Address - Country:US
Practice Address - Phone:910-243-3315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1710I1003X
P8019104146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic