Healthcare Provider Details

I. General information

NPI: 1295956431
Provider Name (Legal Business Name): RICARDO J. SOLER RAMIREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 09/21/2020
Certification Date: 09/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 21 S-3-#1- 2NDO. PISO, URB. LAS LOMAS
SAN JUAN PR
00921
US

IV. Provider business mailing address

P.O. BOX 732 138 WINSTON CHURCHILL AVE.
SAN JUAN PR
00926-6013
US

V. Phone/Fax

Practice location:
  • Phone: 787-782-4405
  • Fax: 787-782-1600
Mailing address:
  • Phone: 787-782-4405
  • Fax: 787-782-1600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number254
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number6589
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number6589
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: