Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT11568 | FL |
NPI | 1003093808 |
---|---|
Provider Name | Mr. Paul Mario Ramos |
First Address | Miami, FL 33176-7909 |
Second Address | Miami, FL 33176-7909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2008 |
Last Update Date | 24/01/2008 |