Provider Demographics
NPI:1992338313
Name:RAMIREZ, MIRTA N
Entity type:Individual
Prefix:
First Name:MIRTA
Middle Name:N
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:CALLE 1 D1
Mailing Address - Street 2:PARQUES DE SAN IGNACIO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-375-8280
Mailing Address - Fax:787-765-1576
Practice Address - Street 1:251 CALLE ROBLE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-3104
Practice Address - Country:US
Practice Address - Phone:787-765-1211
Practice Address - Fax:787-765-1576
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty