Provider Demographics
NPI:1851716211
Name:DR VICENTE LABOY RAMOS CSP
Entity Type:Organization
Organization Name:DR VICENTE LABOY RAMOS CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICENTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LABOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-735-3080
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1559
Mailing Address - Country:US
Mailing Address - Phone:787-735-3080
Mailing Address - Fax:787-735-7095
Practice Address - Street 1:202 CALLE JULIO CINTRON
Practice Address - Street 2:GUAYACAN BUILDING SUITE 105
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3312
Practice Address - Country:US
Practice Address - Phone:787-735-3080
Practice Address - Fax:787-735-7095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7908261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD08803Medicare UPIN