Provider Demographics
NPI:1689645012
Name:RAMOS, JOHANNA M (MT)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:M
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MT
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 250371
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00604-0371
Mailing Address - Country:US
Mailing Address - Phone:787-890-2075
Mailing Address - Fax:787-890-2075
Practice Address - Street 1:124 CALLE BELT
Practice Address - Street 2:BASE RAMEY
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-1106
Practice Address - Country:US
Practice Address - Phone:787-890-2075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5775246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRCF879AOtherPTAN
0031481Medicare ID - Type Unspecified