Provider Demographics
NPI:1467450809
Name:RAMIREZ DIAZ, RAFAEL E
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:E
Last Name:RAMIREZ DIAZ
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 1:429 CALLE REY LUIS
Mailing Address - Street 2:LA VILLA DE TORRIMAR
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3170
Mailing Address - Country:US
Mailing Address - Phone:787-786-8540
Mailing Address - Fax:787-995-0431
Practice Address - Street 1:47 CALLE 1
Practice Address - Street 2:HERMANAS DAVILA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-8023
Practice Address - Country:US
Practice Address - Phone:787-786-8540
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19971223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery