Provider Demographics
NPI:1275516148
Name:RAMIREZ GONZALEZ, JAVIER M (OD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:M
Last Name:RAMIREZ GONZALEZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CALLE CACIQUE
Mailing Address - Street 2:SUITE #5, OCEAN PARK
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-1420
Mailing Address - Country:US
Mailing Address - Phone:787-925-4968
Mailing Address - Fax:
Practice Address - Street 1:1900 CALLE CACIQUE
Practice Address - Street 2:SUITE #5, OCEAN PARK
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1420
Practice Address - Country:US
Practice Address - Phone:787-925-4968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR364152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist