Healthcare Provider Details

I. General information

NPI: 1609491927
Provider Name (Legal Business Name): LILLIAN KARINA ELVIR RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4LS12 VIA LETICIA
CAROLINA PR
00983-4823
US

IV. Provider business mailing address

4LS12 VIA LETICIA
CAROLINA PR
00983-4823
US

V. Phone/Fax

Practice location:
  • Phone: 787-752-4950
  • Fax:
Mailing address:
  • Phone: 787-752-4950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number3412
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: