1326113028 NPI number — MARIA CRISTINA RAMOS ST

Table of content: MARIA CRISTINA RAMOS ST (NPI 1326113028)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326113028 NPI number — MARIA CRISTINA RAMOS ST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMOS
Provider First Name:
MARIA
Provider Middle Name:
CRISTINA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326113028
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6465 WAYZATA BLVD
Provider Second Line Business Mailing Address:
SUITE 900
Provider Business Mailing Address City Name:
ST LOUIS PARK
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55426-1728
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-512-5600
Provider Business Mailing Address Fax Number:
952-512-5650

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3250 W 66TH ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
EDINA
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55435-2528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-920-0970
Provider Business Practice Location Address Fax Number:
952-922-1605
Provider Enumeration Date:
11/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 246ZS0410X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)