Provider Demographics
NPI:1386621043
Name:RAMOS, ENRIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:
Last Name:RAMOS
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:MARGARITA N 13
Mailing Address - Street 2:PARQUES SANTA MARIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-309-4041
Mailing Address - Fax:
Practice Address - Street 1:TORRE AUXILIO MUTUO STE 601
Practice Address - Street 2:AVE PONCE DE LEON 735
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-363-0486
Practice Address - Fax:787-763-6740
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13701174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH55677Medicare UPIN
PR84346Medicare ID - Type Unspecified