Provider Demographics
NPI:1578633327
Name:ORENGO-RAMOS, OSVALDO (MD)
Entity Type:Individual
Prefix:DR
First Name:OSVALDO
Middle Name:
Last Name:ORENGO-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:URB. VALLE ESCONDIDO #1
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677
Mailing Address - Country:US
Mailing Address - Phone:787-432-5672
Mailing Address - Fax:
Practice Address - Street 1:12 #213 JARDINES DEL CARIBE
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:787-432-5672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006156207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI080E610170OtherBLUE CROSS BLUE SHIELD
MI3374390Medicaid
MIC77520Medicare UPIN
MI0A876010082Medicare ID - Type Unspecified