Provider Demographics
NPI:1902162738
Name:MORALES-RAMOS, NELLY ANN MARY
Entity type:Individual
Prefix:
First Name:NELLY ANN
Middle Name:MARY
Last Name:MORALES-RAMOS
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:CAR 190, KM1,H2,INT
Mailing Address - Street 2:BO. SABANA ABAJO
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983
Mailing Address - Country:US
Mailing Address - Phone:787-235-9339
Mailing Address - Fax:
Practice Address - Street 1:190 ST, KM 1, H 2
Practice Address - Street 2:BO. SABANA ABAJO
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-235-9339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8203183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6035202OtherDRIVERS LICENCE
PR8203OtherPHARMACY TECHNICIAN