Provider Demographics
NPI:1760104038
Name:DONIS RAMOS, CLARISA (PA,MHSA,MBA)
Entity Type:Individual
Prefix:
First Name:CLARISA
Middle Name:
Last Name:DONIS RAMOS
Suffix:
Gender:F
Credentials:PA,MHSA,MBA
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 755
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-0755
Mailing Address - Country:US
Mailing Address - Phone:787-934-5011
Mailing Address - Fax:
Practice Address - Street 1:CALLE PROL. CELIS AGUILERA
Practice Address - Street 2:13
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-934-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1225-PA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical