Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OS14236 | FL |
N | 111NI0900X | Internist | OS14236 | FL |
N | 207R00000X | Internist | UO4209 | FL |
N | 111NI0900X | Internist | UO4209 | FL |
Y | 207RC0200X | Critical Care Medicine | OS14236 | FL |
N | 207RP1001X | Pulmonary Disease | OS14236 | FL |
NPI | 1083032411 |
---|---|
Provider Name | Ramon Gustavo Valentin JR. |
First Address | Miramar, FL 33025-3925 |
Second Address | Hollywood, FL 33021-5421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 13/04/2021 |