Healthcare Provider Details

I. General information

NPI: 1184747107
Provider Name (Legal Business Name): GILBERTO RAMOS & CARMEN ALVAREZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 AVE LAGUNA SUITE L106 A
CAROLINA PR
00979-6400
US

IV. Provider business mailing address

PO BOX 8495 FERNANDEZ JUNCO STATION
SAN JUAN PR
00910-0495
US

V. Phone/Fax

Practice location:
  • Phone: 787-253-7070
  • Fax: 787-791-5768
Mailing address:
  • Phone: 787-253-7070
  • Fax: 787-791-5768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number6199
License Number StatePR

VIII. Authorized Official

Name: GILBERTO RAMOS
Title or Position: RADIOLOGIST CO-OWNER
Credential: MD
Phone: 787-253-7070