Medina, Ramon Luis

Medina, Ramon Luis is an sole proprietor health care provider with primary practice located at 125 Woodbury Ln , Canton GA 30114-4590. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Medina, Ramon Luis can be contacted via phone (404) 384-7692.

Contact Information

Primary practice address
125 Woodbury Ln Canton GA 30114-4590
Phone: (404) 384-7692
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Military Health Care Provider 171000000X 161637 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN161637 Georgia

Profile Details

NPI number 1750342366
LBN Legal business name Medina, Ramon Luis
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 31st, 2006
Last updated Jul 15th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750342366 NPPES
Georgia MEDICAID 951483774D
Georgia MEDICAID 951483774E

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