Provider Demographics
NPI:1023999174
Name:RAMALLO, MAIDA ROSA (PA)
Entity type:Individual
Prefix:
First Name:MAIDA
Middle Name:ROSA
Last Name:RAMALLO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7480 BIRD RD STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6630
Mailing Address - Country:US
Mailing Address - Phone:305-667-1080
Mailing Address - Fax:305-397-2671
Practice Address - Street 1:7480 BIRD RD STE 400
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6630
Practice Address - Country:US
Practice Address - Phone:305-667-1080
Practice Address - Fax:305-397-2671
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-297246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty