Provider Demographics
NPI:1629005053
Name:RAMIRO MORALES JR MD PA
Entity type:Organization
Organization Name:RAMIRO MORALES JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MDFACS
Authorized Official - Phone:954-450-6594
Mailing Address - Street 1:12600 PEMBROKE RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2544
Mailing Address - Country:US
Mailing Address - Phone:954-450-6594
Mailing Address - Fax:954-450-1509
Practice Address - Street 1:12600 PEMBROKE RD
Practice Address - Street 2:SUITE 306
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2544
Practice Address - Country:US
Practice Address - Phone:954-450-6594
Practice Address - Fax:954-450-1509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME728072086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG63578Medicare UPIN