MEDICARE: DR. AMARILIS RAMOS-RIVERA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	4324	PR

General Provider Information

NPI Number	:	1033456587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMARILIS RAMOS-RIVERA

Provider Business Mailing Address
First Line	:	PO BOX 3539
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00970-3539
Country	:	US
Telephone Number	:	787-404-5318
Fax Number	:

Provider Business Practice Location Address
First Line	:	HIRAM GONZALEZ 49 C, BAYAMON PUEBLO
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00000-0959
Country	:	US
Telephone Number	:	787-404-5933
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2013
Last Update Date	:	01/03/2013

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