MEDICARE: GLADYS AMELY RAMOS-MALDONADO

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	207X00000X	Orthopaedic Surgery Physician	16708	PR
2	207XP3100X	Pediatric Orthopaedic Surgery Physician	16708	PA

General Provider Information

NPI Number	:	1497873491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLADYS AMELY RAMOS-MALDONADO

Provider Business Mailing Address
First Line	:	690 CALLE CESAR GONZALEZ APT 907
Second Line	:	COND PARQUE DE LAS FUENTES
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3909
Country	:	US
Telephone Number	:	787-756-8370
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 AVE DOMENECH
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3511
Country	:	US
Telephone Number	:	787-756-8370
Fax Number	:

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	10/25/2011

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