Provider Demographics
NPI:1497211999
Name:RAMOS, JESUS MANUEL (RNFA,ARNP)
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:MANUEL
Last Name:RAMOS
Suffix:
Gender:M
Credentials:RNFA,ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15230 NW 89TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1373
Mailing Address - Country:US
Mailing Address - Phone:786-810-0496
Mailing Address - Fax:
Practice Address - Street 1:15230 NW 89TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-1373
Practice Address - Country:US
Practice Address - Phone:786-810-0496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-20
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL110117780163WR0006X
WI16-508246ZC0007X
FL11017780363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant