Provider Demographics
NPI:1255052288
Name:RAMIREZ MORALES, JOEMAR DARIEL I (NA)
Entity type:Individual
Prefix:MISS
First Name:JOEMAR
Middle Name:DARIEL
Last Name:RAMIREZ MORALES
Suffix:I
Gender:M
Credentials:NA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CALLE TULIPAN
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-2436
Mailing Address - Country:US
Mailing Address - Phone:787-679-1030
Mailing Address - Fax:
Practice Address - Street 1:8 CALLE TULIPAN
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-2436
Practice Address - Country:US
Practice Address - Phone:787-679-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4329031172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR661018544Other661018544