Provider Demographics
NPI:1770248957
Name:RAMIREZ REYES, JAYSON
Entity type:Individual
Prefix:
First Name:JAYSON
Middle Name:
Last Name:RAMIREZ REYES
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:CONS MED PLAZA STE 307A
Mailing Address - Street 2:201 AVE GAUTIER BENITEZ
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-957-8282
Mailing Address - Fax:787-665-1165
Practice Address - Street 1:CONS MED PLAZA STE 307A
Practice Address - Street 2:201 AVE GAUTIER BENITEZ
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-957-8282
Practice Address - Fax:787-665-1165
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015903363LF0000X
PR4057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily