Provider Demographics
NPI:1588078067
Name:RAMOS, VIDAL ENRIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:VIDAL
Middle Name:ENRIQUE
Last Name:RAMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:22 ST. 1 MANSIONES TINTILLO HILLS
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-1692
Mailing Address - Country:US
Mailing Address - Phone:939-642-4252
Mailing Address - Fax:787-763-1637
Practice Address - Street 1:22 ST. 1
Practice Address - Street 2:MANSIONES TINTILLO HILLS
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-1692
Practice Address - Country:US
Practice Address - Phone:939-642-4252
Practice Address - Fax:787-763-1637
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18776208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice