Provider Demographics
NPI:1366732661
Name:VIRASORO, RAMON (MD)
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:VIRASORO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAMON
Other - Middle Name:
Other - Last Name:VIRASORO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:225 CLEARFIELD AVE
Mailing Address - Street 2:UROLOGY OF VIRGINIA
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1815
Mailing Address - Country:US
Mailing Address - Phone:757-457-5110
Mailing Address - Fax:757-466-3411
Practice Address - Street 1:225 CLEARFIELD AVE
Practice Address - Street 2:UROLOGY OF VIRGINIA
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1815
Practice Address - Country:US
Practice Address - Phone:757-457-5110
Practice Address - Fax:757-466-3411
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101252501208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty