Provider Demographics
NPI:1750468955
Name:RAMIREZ, HUMBERTO A SR (MD)
Entity Type:Individual
Prefix:DR
First Name:HUMBERTO
Middle Name:A
Last Name:RAMIREZ
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 931
Mailing Address - Street 2:CALLE COLON 160
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-0931
Mailing Address - Country:US
Mailing Address - Phone:787-868-5021
Mailing Address - Fax:787-868-5021
Practice Address - Street 1:161 CALLE MARINA
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3214
Practice Address - Country:US
Practice Address - Phone:787-868-5021
Practice Address - Fax:787-868-5021
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7097208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR28228Medicare ID - Type Unspecified