Provider Demographics
NPI:1225312861
Name:RAMOS, ENRIQUE RENE (AT)
Entity Type:Individual
Prefix:MR
First Name:ENRIQUE
Middle Name:RENE
Last Name:RAMOS
Suffix:
Gender:M
Credentials:AT
Other - Prefix:MR
Other - First Name:ENRIQUE
Other - Middle Name:RENE
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SOCIAL WORKER
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0236
Mailing Address - Country:US
Mailing Address - Phone:787-461-4245
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE CASIA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3200
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR68951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical