Healthcare Provider Details

I. General information

NPI: 1992755839
Provider Name (Legal Business Name): MOISES OMAR RAMIREZ VEGA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 02/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 CALLE PEDRO A DE ALARCON MANS DE ESPANA
MAYAGUEZ PR
00682-6651
US

IV. Provider business mailing address

606 CALLE PEDRO A DE ALARCON MANS DE ESPANA
MAYAGUEZ PR
00682-6651
US

V. Phone/Fax

Practice location:
  • Phone: 787-688-9337
  • Fax: 787-652-4156
Mailing address:
  • Phone: 787-688-9337
  • Fax: 787-652-4156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number16081
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: