Provider Demographics
NPI:1477538478
Name:RAMOS, LUIS B (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:B
Last Name:RAMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 PALMAS INN WAY
Mailing Address - Street 2:PALMANOVA VILLAGE, APT 1102
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-6701
Mailing Address - Country:US
Mailing Address - Phone:787-510-0369
Mailing Address - Fax:
Practice Address - Street 1:500 AVE MUNOZ RIVERA
Practice Address - Street 2:CONDOMINIO EL CENTRO 2 SUITE 21
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-759-7822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11908207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21119Medicare ID - Type Unspecified