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NPI Code Detail

MEDICARE: DR. RAMON E VIDAL MD

MEDICARE:  DR. RAMON E VIDAL  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician8798PR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
52725OTHERPRPREFERRED MEDICARE CHOICE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
128798OTHERPRCIGNA
29100040OTHERPRHUMANA
328798OTHERPRMCS
480705OTHERPRTRIPLE-S
68798OTHERPRPHYSICIAN LICENSE NUMBER

General Provider Information

NPI Number : 1356315196
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAMON E VIDAL MD
Provider Business Mailing Address
First Line : PO BOX 9784
Second Line :
City : SAN JUAN
State : PR
Zip : 00908-0784
Country : US
Telephone Number : 787-282-3000
Fax Number : 787-767-2272
Provider Business Practice Location Address
First Line : 369 DE DIEGO STREET
Second Line : TORRE SAN FRANCISCO SUITE 508
City : SAN JUAN
State : PR
Zip : 00923-0000
Country : US
Telephone Number : 787-282-3000
Fax Number : 787-767-2272
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2006
Last Update Date : 03/21/2011

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Directions to “ DR. RAMON E VIDAL MD” Practice Location

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