Individual provider Active NPI

Manuel De Jesus Ramirez Banqueris, MD

  • General Practice Physician
  • Tampa, FL
National Provider Identifier
1164070330
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1202 Issued in FL
Practice address
400 E Dr Martin Luther King Jr Blvd
Tampa, FL 33603-3866
Phone
(813) 308-4040
NPI assigned
Aug 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 21549 PR
General Practice Physician 208D00000X ACN1202 FL Primary

Addresses

Primary practice location

400 E Dr Martin Luther King Jr Blvd
Tampa, FL 33603-3866

Mailing address

12171 SW 268TH St
Homestead, FL 33032-8001
Phone (305) 278-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211021000761 FL Practitioner - General Practice 2365875879 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN1202FLMDGeneral Practice Physician
21549PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Care of North Florida, Inc Single Specialty Current Accepting new patients
American Care of North Florida, Inc Single Specialty CurrentSince Jul 24, 2024 Accepting new patients
American Care of North Florida, Inc Single Specialty CurrentSince Jul 24, 2024 Accepting new patients

Locations

12171 SW 268th St
Homestead, FL 33032
Phone 30527802001020

1918 Blanding Blvd
Jacksonville, FL 32210
Phone (904) 389-6954

11211 N Nebraska Ave
Tampa, FL 33612
Phone (813) 514-2333

400 E Martin Luther King Blvd
Tampa, FL 33603
Phone (813) 308-4040

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1164070330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12171 SW 268TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330328001",
            "telephone_number": "305-278-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033866",
            "telephone_number": "813-308-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ BANQUERIS",
        "first_name": "MANUEL",
        "middle_name": "DE JESUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-29",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "21549",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.