Provider Demographics
NPI:1700508686
Name:RAMIREZ VAZQUEZ, MAX
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:
Last Name:RAMIREZ VAZQUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 CALLE CASTILLA
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2635
Mailing Address - Country:US
Mailing Address - Phone:787-432-4185
Mailing Address - Fax:
Practice Address - Street 1:513 CALLE CASTILLA
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2635
Practice Address - Country:US
Practice Address - Phone:787-432-4185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program