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General NPI Number Information
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NPI Number | 1851412910
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Entity Type | Individual
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Provider Name | MARIO ANTONIO RAMOS
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 09/15/2019
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Provider Practice Location Address
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Address Line | 369 AVE. DE DIEGO, TORRE SAN FRANCISCO SUITE 307
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City | SAN JUAN
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State | PR
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Zip | 00923-3005
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Country | US
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Telephone | 787-756-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 3 CALLE AMATISTA
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City | SAN JUAN
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State | PR
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Zip | 00926-7046
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Country | US
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Telephone | 787-599-9968
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 11628
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License Number State | PR
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