Provider Demographics
NPI:1356655633
Name:RAMIREZ, MYRNA YVETTE (RPH)
Entity type:Individual
Prefix:
First Name:MYRNA
Middle Name:YVETTE
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 BRISAS DE MONTECASINO
Mailing Address - Street 2:CARIBE
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-402-0712
Mailing Address - Fax:787-474-6948
Practice Address - Street 1:2399 ROUTE #2
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-474-6929
Practice Address - Fax:787-474-6948
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist