Provider Demographics
NPI:1891716486
Name:RAMIREZ-JIMENEZ, CARLOS MOISES (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:MOISES
Last Name:RAMIREZ-JIMENEZ
Suffix:
Gender:M
Credentials:MD
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 1868
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-1868
Mailing Address - Country:US
Mailing Address - Phone:787-264-2495
Mailing Address - Fax:
Practice Address - Street 1:VICTORIA ESQ. SOL #76 STREET
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-1868
Practice Address - Country:US
Practice Address - Phone:787-264-2495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRRA0024977Medicare ID - Type UnspecifiedMEDICAL DOCTOR