Provider Demographics
NPI:1316099567
Name:RAMOS GONZALEZ, IVETTE
Entity type:Individual
Prefix:
First Name:IVETTE
Middle Name:
Last Name:RAMOS GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE MUNOZ RIVERA
Mailing Address - Street 2:#26
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-2201
Mailing Address - Country:US
Mailing Address - Phone:787-829-0183
Mailing Address - Fax:
Practice Address - Street 1:CALLE MUNOZ RIVERA
Practice Address - Street 2:#26
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601-2201
Practice Address - Country:US
Practice Address - Phone:787-829-2495
Practice Address - Fax:787-829-2495
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist