Provider Demographics
NPI:1962506311
Name:FELIX-RAMOS, JUAN
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:FELIX-RAMOS
Suffix:
Gender:M
Credentials:
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 1101
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-1101
Mailing Address - Country:US
Mailing Address - Phone:787-863-2336
Mailing Address - Fax:
Practice Address - Street 1:98 GARRIDO MORALES ST
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-1101
Practice Address - Country:US
Practice Address - Phone:787-863-2336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRD05971223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics