| Park Ave Family Practice | |
|
1345 Thompson Ave South St Paul MN 55075-1410 | |
| (651) 451-2711 | |
| Not Available |
| Full Name | Park Ave Family Practice |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1345 Thompson Ave, South St Paul, Minnesota |
| Authorized Official Name and Position | Karen Lee (MD) |
| Authorized Official Contact | 6128176690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Ave Family Practice 2707 Nicollet Ave Minneapolis MN 55408-1631 Ph: (612) 874-8811 | Park Ave Family Practice 1345 Thompson Ave South St Paul MN 55075-1410 Ph: (651) 451-2711 |
| NPI Number | 1770972382 |
|---|---|
| Provider Enumeration Date | 01/20/2015 |
| Last Update Date | 01/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770972382 | NPI | - | NPPES |
| 100025256 | Medicaid | MN | |
| 080022382 | Other | MN | MEDICARE 080022382 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 43414 (Minnesota) | Primary |
Angelito C Ramos, Md, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1345 Thompson Ave, South St Paul, MN 55075 Phone: 651-451-2711 Fax: 651-453-2017 |