Provider Demographics
NPI:1669412912
Name:ALVAREZ RAMIREZ, ILIANA I (MD)
Entity type:Individual
Prefix:
First Name:ILIANA
Middle Name:I
Last Name:ALVAREZ RAMIREZ
Suffix:
Gender:F
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:PO BOX 586
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-0586
Mailing Address - Country:US
Mailing Address - Phone:787-965-2040
Mailing Address - Fax:787-965-2043
Practice Address - Street 1:602 AVE JOSE EFRON STE 103
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4823
Practice Address - Country:US
Practice Address - Phone:787-965-2040
Practice Address - Fax:787-965-2043
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME696412085R0202X
PR0113942085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2755220 00Medicaid
FL2755220 00Medicaid
FLG87362Medicare UPIN