Provider Demographics
NPI:1518956457
Name:RAMOS MENDEZ, EDGAR JACINTO (MD)
Entity Type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:JACINTO
Last Name:RAMOS MENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 153
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-0153
Mailing Address - Country:US
Mailing Address - Phone:787-846-3649
Mailing Address - Fax:787-623-2849
Practice Address - Street 1:CARR 682 KW 3,5
Practice Address - Street 2:
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-846-3649
Practice Address - Fax:787-623-2849
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12615207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H72797Medicare UPIN
PR0081440Medicare PIN