Provider Demographics
NPI:1922046838
Name:ARRAUT RAMIREZ, HARLEY (MD)
Entity Type:Individual
Prefix:
First Name:HARLEY
Middle Name:
Last Name:ARRAUT RAMIREZ
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 4145
Mailing Address - Street 2:
Mailing Address - City:PUERTO REAL
Mailing Address - State:PR
Mailing Address - Zip Code:00740-4145
Mailing Address - Country:US
Mailing Address - Phone:787-810-7515
Mailing Address - Fax:
Practice Address - Street 1:L2 CALLE 6
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-2825
Practice Address - Country:US
Practice Address - Phone:787-888-8886
Practice Address - Fax:787-888-8887
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12271207Q00000X, 208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG-44105Medicare UPIN
PR88885Medicare ID - Type Unspecified