Provider Demographics
NPI:1497862122
Name:PIZARRO FORNARIS, RAMON A (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:A
Last Name:PIZARRO FORNARIS
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:TINTILLO HILLS 5062
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-249-2240
Mailing Address - Fax:
Practice Address - Street 1:#5062
Practice Address - Street 2:URB TINTILLO HILLS
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-2907
Practice Address - Country:US
Practice Address - Phone:787-249-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR110212085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
84203Medicare ID - Type Unspecified