Provider Demographics
NPI:1609957117
Name:DE JESUS RAMOS, MIGUEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:A
Last Name:DE JESUS RAMOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:AVE GENERAL VALERO # 410
Mailing Address - Street 2:TORRE MEDICA 403
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-3949
Mailing Address - Country:US
Mailing Address - Phone:787-655-4006
Mailing Address - Fax:787-801-0721
Practice Address - Street 1:194 KM 2 HM 4 AVE. GENERAL VALERO
Practice Address - Street 2:204
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-863-0505
Practice Address - Fax:787-801-0721
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2011-09-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR12253208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR060192OtherCRUZ AZUL
PR88599OtherTRIPLE S
PR88599OtherTRIPLE S