MEDICARE: DR. JORGE R. RAMIREZ-MONTALVO M.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	146M00000X	Intermediate Emergency Medical Technician	16072	PR

General Provider Information

NPI Number	:	1902893381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORGE R. RAMIREZ-MONTALVO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 560102
Second Line	:
City	:	GUAYANILLA
State	:	PR
Zip	:	00656-0102
Country	:	US
Telephone Number	:	787-835-6423
Fax Number	:

Provider Business Practice Location Address
First Line	:	STREET PEDRO VELAZQUEZ NO 628
Second Line	:	EDIF AURORA A9
City	:	PENUELAS
State	:	PR
Zip	:	00624
Country	:	US
Telephone Number	:	787-386-2686
Fax Number	:

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	03/06/2008

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