Healthcare Provider Details

I. General information

NPI: 1215910294
Provider Name (Legal Business Name): JOSE JORGE RAMOS-HERNANDEZ D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 CALLE CULTO
COROZAL PR
00783-2051
US

IV. Provider business mailing address

PO BOX 487
BAYAMON PR
00960-0487
US

V. Phone/Fax

Practice location:
  • Phone: 787-859-6228
  • Fax: 787-706-8314
Mailing address:
  • Phone: 787-774-1454
  • Fax: 787-706-8314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1771
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: