Basic Information
| Provider Information | |||||||||
| NPI: | 1285606996 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMIREZ | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | M.D, | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6101 BLUE LAGOON DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331263168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157051725 | ||||||||
| FaxNumber: | 8647257707 | ||||||||
| Practice Location | |||||||||
| Address1: | 1860 S SEGUIN AVE BLDG E | ||||||||
| Address2: | |||||||||
| City: | NEW BRAUNFELS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781303914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8306267770 | ||||||||
| FaxNumber: | 8553476311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2006 | ||||||||
| LastUpdateDate: | 10/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | L0528 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 044881302 | 05 | TX | MEDICAID | 110232143 | 01 | TX | MEDICARE RAILROAD | OTHER |