Healthcare Provider Details

I. General information

NPI: 1841251683
Provider Name (Legal Business Name): MARIA DEL CARMEN BALLESTEROS RAMOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 12/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAN VICENTE 212 CONCORDIA 8169
PONCE PR
00713-1559
US

IV. Provider business mailing address

3129 EMILIO FAGOT
LA RANBLA PR
00730-4000
US

V. Phone/Fax

Practice location:
  • Phone: 787-259-4312
  • Fax: 787-848-7479
Mailing address:
  • Phone: 787-842-1011
  • Fax: 787-848-7479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number10009
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: