Healthcare Provider Details

I. General information

NPI: 1437109485
Provider Name (Legal Business Name): CARLA R LLAVONA-RAMIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COND MONTE MAYOR 44 ST, JUAN C BORBON, SUITE 733
GUAYNABO PR
00969-4001
US

IV. Provider business mailing address

COND MONTE MAYOR 44 ST, JUAN C BORBON, SUITE 733
GUAYNABO PR
00969-4001
US

V. Phone/Fax

Practice location:
  • Phone: 787-600-2312
  • Fax:
Mailing address:
  • Phone: 787-600-2312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number13465
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: