Provider Demographics
NPI:1265789861
Name:RODRIGUEZ RAMOS, IVONNE YAMIL
Entity type:Individual
Prefix:
First Name:IVONNE
Middle Name:YAMIL
Last Name:RODRIGUEZ RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 26910
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-8933
Mailing Address - Country:US
Mailing Address - Phone:787-737-6493
Mailing Address - Fax:787-737-6493
Practice Address - Street 1:ROAD 189 KM 6.4 MARINA PLAZA
Practice Address - Street 2:SUITE 17
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-4200
Practice Address - Country:US
Practice Address - Phone:787-737-6493
Practice Address - Fax:787-737-6493
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1036225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist