Provider Demographics
NPI:1265499735
Name:RAMOS, EXA L (OD)
Entity Type:Individual
Prefix:
First Name:EXA
Middle Name:L
Last Name:RAMOS
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:CALLE LA PAZ 257
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602
Mailing Address - Country:US
Mailing Address - Phone:787-868-7025
Mailing Address - Fax:787-868-7025
Practice Address - Street 1:CALLE LA PAZ 257
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-868-7025
Practice Address - Fax:787-868-7025
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00602152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
58056Medicare ID - Type Unspecified