Provider Demographics
NPI:1770652463
Name:BOSCH-RAMIREZ, MARCIAL VICTOR (MD ANESTHESIOLOGIST)
Entity Type:Individual
Prefix:
First Name:MARCIAL
Middle Name:VICTOR
Last Name:BOSCH-RAMIREZ
Suffix:
Gender:M
Credentials:MD ANESTHESIOLOGIST
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 144100
Mailing Address - Street 2:PMB 121
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-4100
Mailing Address - Country:US
Mailing Address - Phone:787-650-7313
Mailing Address - Fax:787-650-7313
Practice Address - Street 1:CARR 129 KIL .8
Practice Address - Street 2:AVENIDA SAN LUIS
Practice Address - City:ARRECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-650-7313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5709207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
26896Medicare ID - Type Unspecified