Basic Information
| Provider Information | |||||||||
| NPI: | 1235101486 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMOS | ||||||||
| FirstName: | LUIS | ||||||||
| MiddleName: | GERMAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1580 SANTA BARBARA BLVD | ||||||||
| Address2: | |||||||||
| City: | THE VILLAGES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321596827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522592159 | ||||||||
| FaxNumber: | 3526744386 | ||||||||
| Practice Location | |||||||||
| Address1: | 13696 N US HIGHWAY 441 | ||||||||
| Address2: | |||||||||
| City: | LADY LAKE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321596814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525081502 | ||||||||
| FaxNumber: | 3526744386 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 182441 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | L9863 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | ME78186 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 167720502 | 05 | TX | MEDICAID | E5573T | 01 | FL | MEDICARE PTAN | OTHER |