Provider Demographics
NPI:1750362018
Name:BERMUDEZ RAMIREZ, OLGA W (MD)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:W
Last Name:BERMUDEZ RAMIREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:439 BLVD DE LOS ARBOLES
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7160
Mailing Address - Country:US
Mailing Address - Phone:787-525-9275
Mailing Address - Fax:787-789-3596
Practice Address - Street 1:HOSPITAL MENONITA, GUAYAMA
Practice Address - Street 2:URB. LA HACIENDA AVE PEDRO ALBIZU CAMPOS
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-0011
Practice Address - Country:US
Practice Address - Phone:787-864-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13109208100000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH10914Medicare UPIN