Provider Demographics
NPI:1811978018
Name:PADUA-RAMOS, ANTONIO MARIANO (MD)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:MARIANO
Last Name:PADUA-RAMOS
Suffix:
Gender:M
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:CPR PROFESSIONAL BUILDING
Mailing Address - Street 2:55 CALLE DE DIEGO ESTE SUITE 401
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-5081
Mailing Address - Country:US
Mailing Address - Phone:787-832-0000
Mailing Address - Fax:787-265-4335
Practice Address - Street 1:CPR PROFESSIONAL BUILDING
Practice Address - Street 2:55 CALLE DE DIEGO ESTE SUITE 401
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-5081
Practice Address - Country:US
Practice Address - Phone:787-832-0000
Practice Address - Fax:787-265-4335
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10139207RP1001X, 207R00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1811978018Medicaid
0082339Medicare ID - Type Unspecified