Provider Demographics
NPI:1700021136
Name:RAMOS GONZALEZ, JUAN M (M D)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:M
Last Name:RAMOS GONZALEZ
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 CALLE REY FERNANDO
Mailing Address - Street 2:URB. MANSION REAL
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2625
Mailing Address - Country:US
Mailing Address - Phone:787-955-5516
Mailing Address - Fax:
Practice Address - Street 1:113 CALLE REY FERNANDO
Practice Address - Street 2:URB. MANSION REAL
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2625
Practice Address - Country:US
Practice Address - Phone:787-955-5516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14878208D00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice