Provider Demographics
NPI:1922309335
Name:ESSENTIAL MEDICINE INC,
Entity Type:Organization
Organization Name:ESSENTIAL MEDICINE INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-392-1051
Mailing Address - Street 1:PO BOX 183
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-0183
Mailing Address - Country:US
Mailing Address - Phone:787-866-5544
Mailing Address - Fax:787-866-5544
Practice Address - Street 1:64 CALLE BALDORIOTY W
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-5337
Practice Address - Country:US
Practice Address - Phone:787-866-5544
Practice Address - Fax:787-866-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12073208D00000X
PR17490208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty