Healthcare Provider Details

I. General information

NPI: 1437359957
Provider Name (Legal Business Name): MRS. JESSICA RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 07/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE AGUSTIN RAMOS CALERO INT 111
ISABELA PR
00662
US

IV. Provider business mailing address

HC 2 10077
QUEBRADILLAS PR
00678
US

V. Phone/Fax

Practice location:
  • Phone: 787-830-2765
  • Fax: 787-830-0465
Mailing address:
  • Phone: 787-895-4187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number31563
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: