Provider Demographics
NPI:1063598266
Name:BERMUDEZ-DEL VALLE, RAMON H (MD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:H
Last Name:BERMUDEZ-DEL VALLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1737
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-1737
Mailing Address - Country:US
Mailing Address - Phone:787-789-3733
Mailing Address - Fax:787-789-3733
Practice Address - Street 1:AVE PONCE DE LEON PDA 371/2
Practice Address - Street 2:HOSPITAL AUXILIO MUTUO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919-1227
Practice Address - Country:US
Practice Address - Phone:787-447-0826
Practice Address - Fax:787-789-3733
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16253020207RI0200X
PR2657207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
66040OtherMAPPRE
234020OtherPREFERRED HEALTH
10391OtherHUMANA
0092628Medicare ID - Type Unspecified
10391OtherHUMANA