Provider Demographics
NPI:1801863865
Name:RAMON-VILLARONGA, LUIS G (PHD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:G
Last Name:RAMON-VILLARONGA
Suffix:
Gender:M
Credentials:PHD
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 786
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677-0786
Mailing Address - Country:US
Mailing Address - Phone:787-252-1927
Mailing Address - Fax:
Practice Address - Street 1:416 ST. K8.7 ATALAYA, AGUADA PR 00602
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:PR
Practice Address - Zip Code:00677
Practice Address - Country:US
Practice Address - Phone:787-252-1927
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0723103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0021444Medicare ID - Type Unspecified