Provider Demographics
NPI:1659497345
Name:RAMIREZ, JAVIER ENRIQUE (OPTICO)
Entity Type:Individual
Prefix:MR
First Name:JAVIER
Middle Name:ENRIQUE
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:OPTICO
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 227
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-0227
Mailing Address - Country:US
Mailing Address - Phone:787-899-1800
Mailing Address - Fax:787-899-1800
Practice Address - Street 1:JOSE M. TORO
Practice Address - Street 2:BASORA # 4
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667
Practice Address - Country:US
Practice Address - Phone:787-899-1800
Practice Address - Fax:787-899-1800
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR224156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR100259OtherCRUZ AZUL DE PUERTO RICO
PR8078OtherFIRST MEDICAL CARD
PR100259OtherCRUZ AZUL DE PUERTO RICO