Provider Demographics
NPI:1639101926
Name:ORTIZ CARRASQUILLO, RAMON (MD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:ORTIZ CARRASQUILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HACIENDAS HERMANAS MENA AV
Mailing Address - Street 2:AEV. PASEO VICTORIA #112
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-854-3700
Mailing Address - Fax:787-884-4455
Practice Address - Street 1:DOCTOR'S CENTER HOSPITAL
Practice Address - Street 2:CARR 2 KM 47.7
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-690-0096
Practice Address - Fax:787-884-4455
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4852174400000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR601900OtherMMM
PR0657OtherCRUZ AZUL
PR583200672OtherALL OTHER INSURANCES
PRC84089Medicare UPIN