Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. RAMON OMAR VICENCIO, MD
Active Sole ProprietorDR. RAMON OMAR VICENCIO, MD is a Sports Medicine healthcare provider located in PHILADELPHIA, Pennsylvania. NPI 1083292130 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · PHILADELPHIA, PA
Registration Details
- NPI Number
- 1083292130
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 31, 2021 (5.346868729517 yrs)
- Last Updated
- Jan 29, 2026
- License
-
MD484891 (PA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
10 SHURS LNPHILADELPHIA, PA, 191272123Browse PA providers · Browse ZIP 19127
- Phone
- 2154821234
- Fax
- 2154820465
- Primary Specialty
-
Sports Medicine
207QS0010X
Other Sports Medicine Providers in PHILADELPHIA, PA
| Name | Credential | NPI |
|---|---|---|
| CHRISTOPHER JON MEHALLO | D.O. | 1730103706 |
| DR. NICOLE OTTO | M.D. | 1306915335 |
| BARRY E KENNEALLY | MD | 1629147558 |
| ROSEMARIE BOEHM | M.D. | 1598837700 |
| DR. JEREMY DAVID CLOSE | M.D. | 1114049566 |
| DR. DANIEL JOSEPH MORRISSY III | D.O. | 1013130020 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.