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Individual

DR. RAMON EDMUNDO BAUTISTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
580 W 8TH ST, UFJP NEUROLOGY, JACKSONVILLE, FL 32209-6533
(904) 244-3961
(904) 244-3425
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLMENT, JACKSONVILLE, FL 32231-4008

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
037951
GA
2084N0400X
Neurology Physician
Primary
ME82495
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000877016A
GA
05
000877016C
GA
05
2587718-00
FL
Enumeration date
03/14/2006
Last updated
04/07/2009
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