MEDICARE: NELSON DE JESUS RAMOS 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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	7270	PR

General Provider Information

NPI Number	:	1912978958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NELSON DE JESUS RAMOS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 51393
Second Line	:
City	:	TOA BAJA
State	:	PR
Zip	:	00950-1393
Country	:	US
Telephone Number	:	787-381-1220
Fax Number	:

Provider Business Practice Location Address
First Line	:	652 AVE SAN PATRICIO
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00920-4509
Country	:	US
Telephone Number	:	787-210-7628
Fax Number	:	787-792-0635

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

Provider Enumeration Date	:	01/29/2006
Last Update Date	:	10/02/2012

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