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Individual

JAIME R RONCANCIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2500 SW 75TH AVE, MIAMI, FL 33155-2805
(305) 264-5252
(800) 536-8431
Mailing address
PO BOX 863481, ORLANDO, FL 32886-3481
(800) 514-1494
(904) 805-1302

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS0007634
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
258231700
FL
01
49699
BCBS
FL
01
P00367253
RR MCR
FL
Enumeration date
05/04/2006
Last updated
05/22/2008
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