Provider Demographics
NPI:1841281300
Name:RAMIREZ SOTO, MANUEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:A
Last Name:RAMIREZ SOTO
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:PO BOX 542
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-0542
Mailing Address - Country:US
Mailing Address - Phone:787-892-9290
Mailing Address - Fax:787-892-9290
Practice Address - Street 1:100 AVE. HERNAN ALVAREZ
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4173
Practice Address - Country:US
Practice Address - Phone:787-892-3318
Practice Address - Fax:787-892-9290
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5501208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0027082Medicare ID - Type Unspecified
C77492Medicare UPIN