Individual provider Active NPI

Carlos Antonio Ramirez Proenza, PA

  • Physician Assistant
  • Pembroke Pines, FL
National Provider Identifier
1093603342
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002617-P.A. Issued in PR
Practice address
1251 NW 122ND Ter
Pembroke Pines, FL 33026-3819
Phone
(305) 924-5848
NPI assigned
Jun 25, 2025
Last updated
Jun 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002617-P.A. PR Primary
Surgical Physician Assistant 363AS0400X 002617-P.A. PR
Surgical Assistant 246ZC0007X 16-115 FL

Addresses

Primary practice location

1251 NW 122ND Ter
Pembroke Pines, FL 33026-3819

Mailing address

1251 NW 122ND Ter
Pembroke Pines, FL 33026-3819
Phone (305) 924-5848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
16-115FLMDSurgical Assistant
002617-P.A.PRMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1093603342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 NW 122ND TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263819",
            "telephone_number": "305-924-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 NW 122ND TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263819",
            "telephone_number": "305-924-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ PROENZA",
        "first_name": "CARLOS",
        "middle_name": "ANTONIO",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "002617-P.A.",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PR",
            "license": "002617-P.A.",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "16-115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.