Basic Information
| Provider Information | |||||||||
| NPI: | 1003142555 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMIREZ | ||||||||
| FirstName: | JOANNA | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 214 MORRISON RD | ||||||||
| Address2: | STE 110 | ||||||||
| City: | BRANDON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335114849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138444300 | ||||||||
| FaxNumber: | 8138441909 | ||||||||
| Practice Location | |||||||||
| Address1: | 214 MORRISON RD | ||||||||
| Address2: | STE 110 | ||||||||
| City: | BRANDON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335114849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138444300 | ||||||||
| FaxNumber: | 8138441909 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2009 | ||||||||
| LastUpdateDate: | 09/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | BP10025229 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | ME107535 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | ME107535 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 003192200 | 05 | FL | MEDICAID |