Provider Demographics
NPI:1013778513
Name:REYES RAMOS, JOHN JAVIER
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JAVIER
Last Name:REYES 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 361800
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1800
Mailing Address - Country:US
Mailing Address - Phone:787-627-9555
Mailing Address - Fax:
Practice Address - Street 1:1783 CALLE SANTA AGUEDA APT 1001
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4376
Practice Address - Country:US
Practice Address - Phone:787-627-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist