1881607661 NPI number — RAMON A GUEVARA DO

Table of content: RAMON A GUEVARA DO (NPI 1881607661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881607661 NPI number — RAMON A GUEVARA DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUEVARA
Provider First Name:
RAMON
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

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:
1881607661
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
240 CRANDON BLVD
Provider Second Line Business Mailing Address:
SUITE 212
Provider Business Mailing Address City Name:
KEY BISCAYNE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33149-1543
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-361-6232
Provider Business Mailing Address Fax Number:
305-365-0031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45 NW 8TH ST STE 110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMESTEAD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33030-4452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-248-1900
Provider Business Practice Location Address Fax Number:
305-248-1902
Provider Enumeration Date:
08/14/2006

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: 208000000X , with the licence number:  OS6587 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: OS6587 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1306687 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 373671700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 373671701 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 005429 . This is a "NHP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 910770300 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1348134 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 170689 . This is a "HUMANA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 170753 . This is a "HUMANA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 18936 . This is a "WELLCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 18936 . This is a "STAYWELL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 4605196 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: FM4371 . This is a "HEALTHNET" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 103935 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 18936 . This is a "HEALTHEASE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5210124 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 80835 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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