Provider Demographics
NPI:1053641902
Name:RAMOS RIVERA, AITZAMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:AITZAMAR
Middle Name:
Last Name:RAMOS RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STREET #4 JARDINES DE ANASCO
Mailing Address - Street 2:D-2
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610
Mailing Address - Country:US
Mailing Address - Phone:787-225-8184
Mailing Address - Fax:
Practice Address - Street 1:CALLE GEORGETTI INT.CALLE OBRERO C-8
Practice Address - Street 2:EDIFICIO MARINA II CARR 140 KM 68.5
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-623-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17249208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice