MEDICARE: DR. JAVIER M RAMIREZ GONZALEZ O.D.

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	152W00000X	Optometrist	364	PR

General Provider Information

NPI Number	:	1275516148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAVIER M RAMIREZ GONZALEZ O.D.

Provider Business Mailing Address
First Line	:	1900 CALLE CACIQUE
Second Line	:	SUITE #5, OCEAN PARK
City	:	SAN JUAN
State	:	PR
Zip	:	00911-1420
Country	:	US
Telephone Number	:	787-925-4968
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 CALLE CACIQUE
Second Line	:	SUITE #5, OCEAN PARK
City	:	SAN JUAN
State	:	PR
Zip	:	00911-1420
Country	:	US
Telephone Number	:	787-925-4968
Fax Number	:

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

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	04/08/2019

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