Provider Demographics
NPI:1902437528
Name:RAMIREZ, TARA SOFIA
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:SOFIA
Last Name:RAMIREZ
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 1:600 BLVD DE LA MONTANA APT 523
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7123
Mailing Address - Country:US
Mailing Address - Phone:787-385-4886
Mailing Address - Fax:
Practice Address - Street 1:600 BLVD DE LA MONTANA APT 523
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7123
Practice Address - Country:US
Practice Address - Phone:787-385-4886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-02
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program