Provider Demographics
NPI:1073096947
Name:RAMOS- ARROYO, RAISA ANETTE
Entity Type:Individual
Prefix:
First Name:RAISA
Middle Name:ANETTE
Last Name:RAMOS- ARROYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CALLE DOCTOR EMETERIO BETANCES
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2820 BRIARWOOD LN
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33875-4760
Practice Address - Country:US
Practice Address - Phone:813-287-5718
Practice Address - Fax:813-287-5728
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL105557367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered