Provider Demographics
NPI:1790383313
Name:RAMOS, AIDA LUZ
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:LUZ
Last Name:RAMOS
Suffix:
Gender:F
Credentials:
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 1701
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-1701
Mailing Address - Country:US
Mailing Address - Phone:787-444-3610
Mailing Address - Fax:
Practice Address - Street 1:CARR 111 KM 7.1 EDIFICIO PLAZA SOL BO. VOLADORAS
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-9617
Practice Address - Country:US
Practice Address - Phone:787-877-3696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist