Provider Demographics
NPI:1003151267
Name:RAMIREZ CRUZ, ROSELYN ENID (OD)
Entity Type:Individual
Prefix:MISS
First Name:ROSELYN
Middle Name:ENID
Last Name:RAMIREZ CRUZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 AVE MUNOZ RIVERA APT 615
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00901-2472
Mailing Address - Country:US
Mailing Address - Phone:939-717-7573
Mailing Address - Fax:
Practice Address - Street 1:25 AVE MUNOZ RIVERA APT 615
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-2472
Practice Address - Country:US
Practice Address - Phone:939-717-7573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR697152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist