Healthcare Provider Details

I. General information

NPI: 1821464108
Provider Name (Legal Business Name): GYNE-OB MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 AVE FD ROOSEVELT OFC 701
SAN JUAN PR
00918-8056
US

IV. Provider business mailing address

BC20 AMAZONA SUR URB. VALLE VERDE 2
BAYAMON PR
00961
US

V. Phone/Fax

Practice location:
  • Phone: 787-461-5677
  • Fax:
Mailing address:
  • Phone: 787-461-5677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. YURIZAM RAMIREZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-461-5677