Provider Demographics
NPI:1801969639
Name:FORTUNO-RAMIREZ, RAMON O (MD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:O
Last Name:FORTUNO-RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAMON
Other - Middle Name:O
Other - Last Name:FORTUNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2000 CARR. 8177
Mailing Address - Street 2:SUITE 26 PMB358
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-3762
Mailing Address - Country:US
Mailing Address - Phone:939-644-5718
Mailing Address - Fax:787-756-7363
Practice Address - Street 1:1866 CALLE SAN JOAQUIN
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5337
Practice Address - Country:US
Practice Address - Phone:787-756-5604
Practice Address - Fax:787-756-7363
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0092972084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRBPA1025-11-20046OtherODAR SAN JUAN HHRS
PRFO81140OtherTRIPLE-S HEALTH INS.
PR032071255OtherD-U-N-S
PREO9374Medicare UPIN
PR81140Medicare PIN