=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366476236
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATIA GARCIA RAMOS MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2006
-----------------------------------------------------
Last Update Date | 05/23/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | C15 CALLE PLATERO VILLAS DE CUPEY
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00926-7608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-565-0169
-----------------------------------------------------
Fax | 787-650-7304
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | C15 CALLE PLATERO VILLAS DE CUPEY
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00926-7608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-565-0169
-----------------------------------------------------
Fax | 787-650-7304
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0202X
-----------------------------------------------------
Taxonomy Name | Diagnostic Radiology Physician
-----------------------------------------------------
License Number | 13292
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------