Healthcare Provider Details

I. General information

NPI: 1316946536
Provider Name (Legal Business Name): MIGUEL A. RAMIREZ-SOTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 02/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 CALLE LOPEZ HORMAZABAL
JUNCOS PR
00777-3105
US

IV. Provider business mailing address

40 CALLE LOPEZ HORMAZABAL
JUNCOS PR
00777-3105
US

V. Phone/Fax

Practice location:
  • Phone: 178-773-4060
  • Fax: 178-773-4060
Mailing address:
  • Phone: 178-773-4060
  • Fax: 178-773-4060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number9059
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: