Healthcare Provider Details

I. General information

NPI: 1184724049
Provider Name (Legal Business Name): JAIME RAMOS COUVERTIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE RAMON RIOS ROMAN CARRETERA 866 NUMERO 79-D BARRIO SABANA SECA
TOA BAJA PR
00952-0751
US

IV. Provider business mailing address

PO BOX 751
SABANA SECA PR
00952-0751
US

V. Phone/Fax

Practice location:
  • Phone: 787-784-5225
  • Fax: 787-784-5225
Mailing address:
  • Phone: 787-784-5225
  • Fax: 787-784-5225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number10358
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: