Provider Demographics
NPI:1750464897
Name:HUERTAS-RAMOS, ANGEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:
Last Name:HUERTAS-RAMOS
Suffix:
Gender:M
Credentials:MD
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 2275
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2275
Mailing Address - Country:US
Mailing Address - Phone:787-864-5233
Mailing Address - Fax:787-864-5233
Practice Address - Street 1:CARR #3 KM143.8
Practice Address - Street 2:BO PUENTE JOBOS
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-5233
Practice Address - Fax:787-864-5233
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11276261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG04598Medicare UPIN
PR0084477Medicare ID - Type Unspecified