Healthcare Provider Details

I. General information

NPI: 1235413303
Provider Name (Legal Business Name): UBALDINO RAMIREZ DE ARELLANO-LATONI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2011
Last Update Date: 05/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 AVE TITO CASTRO
PONCE PR
00716-4717
US

IV. Provider business mailing address

PO BOX 801133
COTO LAUREL PR
00780-1133
US

V. Phone/Fax

Practice location:
  • Phone: 787-843-3031
  • Fax:
Mailing address:
  • Phone: 787-709-0705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number18613
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: