Healthcare Provider Details

I. General information

NPI: 1073096947
Provider Name (Legal Business Name): RAISA ANETTE RAMOS- ARROYO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2018
Last Update Date: 01/07/2020
Certification Date: 01/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 BRIARWOOD LN
SEBRING FL
33875-4760
US

IV. Provider business mailing address

18 CALLE DOCTOR EMETERIO BETANCES
MAYAGUEZ PR
00680
US

V. Phone/Fax

Practice location:
  • Phone: 813-287-5718
  • Fax: 813-287-5728
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number105557
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: