Healthcare Provider Details

I. General information

NPI: 1811978018
Provider Name (Legal Business Name): ANTONIO MARIANO PADUA-RAMOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CPR PROFESSIONAL BUILDING 55 CALLE DE DIEGO ESTE SUITE 401
MAYAGUEZ PR
00680-5081
US

IV. Provider business mailing address

CPR PROFESSIONAL BUILDING 55 CALLE DE DIEGO ESTE SUITE 401
MAYAGUEZ PR
00680-5081
US

V. Phone/Fax

Practice location:
  • Phone: 787-832-0000
  • Fax: 787-265-4335
Mailing address:
  • Phone: 787-832-0000
  • Fax: 787-265-4335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number10139
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number10139
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number10139
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: