Provider Demographics
NPI:1598041071
Name:RAMOS, MARIELA ENID (DMD)
Entity Type:Individual
Prefix:
First Name:MARIELA
Middle Name:ENID
Last Name:RAMOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2673
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2673
Mailing Address - Country:US
Mailing Address - Phone:787-406-2301
Mailing Address - Fax:
Practice Address - Street 1:AVE AMERICO MIRANDA UPR SCHOOL OD DENTAL MEDICNE
Practice Address - Street 2:OFIC. 129
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice