Healthcare Provider Details

I. General information

NPI: 1265063572
Provider Name (Legal Business Name): EMILISSE FRANCHESKA RAMOS LND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 01/04/2021
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KM 13., 3 CALLE 4
CAROLINA PR
00918
US

IV. Provider business mailing address

URB. LOS DOMINICOS CALLE SAN AGUSTIN B43
BAYAMON PR
00957
US

V. Phone/Fax

Practice location:
  • Phone: 787-993-4990
  • Fax:
Mailing address:
  • Phone: 787-585-6669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number2122
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: