Provider Demographics
NPI:1184605669
Name:RODRIGUEZ RAMOS, ULISES
Entity type:Individual
Prefix:DR
First Name:ULISES
Middle Name:
Last Name:RODRIGUEZ RAMOS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:ULISES
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1406
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-1406
Mailing Address - Country:US
Mailing Address - Phone:787-812-0700
Mailing Address - Fax:787-812-0707
Practice Address - Street 1:EDIF PARRAS
Practice Address - Street 2:SUITE 908
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1321
Practice Address - Country:US
Practice Address - Phone:787-812-0700
Practice Address - Fax:787-812-0707
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11148174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0084202Other0084202