Provider Demographics
NPI:1962899278
Name:RAMOS, KEISALIZ (10324 RPH)
Entity type:Individual
Prefix:MS
First Name:KEISALIZ
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:10324 RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 64 BOX 8421
Mailing Address - Street 2:B GUARDARRAYA SECTOR COFRESI
Mailing Address - City:PATILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00723-9783
Mailing Address - Country:US
Mailing Address - Phone:787-243-4479
Mailing Address - Fax:
Practice Address - Street 1:HC 64 BOX 8421
Practice Address - Street 2:B GUARDARRAYA SECTOR COFRESI
Practice Address - City:PATILLAS
Practice Address - State:PR
Practice Address - Zip Code:00723-9783
Practice Address - Country:US
Practice Address - Phone:787-243-4479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10324183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4844574OtherLICENSE
PR10324OtherLICENSE OF PHARMACY