MEDICARE: DR. RAMON H BERMUDEZ-DEL VALLE MD

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	207RI0200X	Infectious Disease Physician	16253020	WI
2	207RI0200X	Infectious Disease Physician	2657	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	66040	OTHER	MAPPRE
2	234020	OTHER	PREFERRED HEALTH
3	10391	OTHER	HUMANA

General Provider Information

NPI Number	:	1063598266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMON H BERMUDEZ-DEL VALLE MD

Provider Business Mailing Address
First Line	:	PO BOX 1737
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00970-1737
Country	:	US
Telephone Number	:	787-789-3733
Fax Number	:	787-789-3733

Provider Business Practice Location Address
First Line	:	AVE PONCE DE LEON PDA 371/2
Second Line	:	HOSPITAL AUXILIO MUTUO
City	:	SAN JUAN
State	:	PR
Zip	:	00919-1227
Country	:	US
Telephone Number	:	787-447-0826
Fax Number	:	787-789-3733

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

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	03/22/2019

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