Provider Demographics
NPI:1144561069
Name:ESQUIBEL, RAMON GABRIEL
Entity Type:Individual
Prefix:MR
First Name:RAMON
Middle Name:GABRIEL
Last Name:ESQUIBEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 69 BOX 3001
Mailing Address - Street 2:
Mailing Address - City:ROCIADA
Mailing Address - State:NM
Mailing Address - Zip Code:87742-9710
Mailing Address - Country:US
Mailing Address - Phone:505-454-4832
Mailing Address - Fax:505-454-4832
Practice Address - Street 1:2810 HOT SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4119
Practice Address - Country:US
Practice Address - Phone:505-304-0098
Practice Address - Fax:505-454-4832
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6911225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist