Provider Demographics
NPI:1194173252
Name:DIAZ-RAMOS, NICOLE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:MARIE
Last Name:DIAZ-RAMOS
Suffix:
Gender:F
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:BARRIO MONACILLOS CARR. 22, CENTRO MEDICO
Mailing Address - Street 2:HOSPITAL PEDIATRICO UNIVERSITARIO DR. ANTONIO ORTIZ
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00935
Mailing Address - Country:US
Mailing Address - Phone:787-753-6390
Mailing Address - Fax:
Practice Address - Street 1:METROPOLITAN HOSPITAL DR. SUSONI
Practice Address - Street 2:#55 CALLE PALMA
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-539-3554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21241208000000X, 207K00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program