Provider Demographics
NPI:1699725010
Name:RAMOS MARTINEZ, JUAN C (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:C
Last Name:RAMOS MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:138 WINSTON CHURCHILL AVE
Mailing Address - Street 2:PMB 659
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00778-5245
Mailing Address - Country:US
Mailing Address - Phone:787-614-5231
Mailing Address - Fax:787-293-1004
Practice Address - Street 1:361 CALLE SGTO LUIS MEDINA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3817
Practice Address - Country:US
Practice Address - Phone:787-614-5231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14594208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0021189Medicare ID - Type Unspecified