Provider Demographics
NPI:1881976009
Name:RAMIREZ, LEONARDO
Entity type:Individual
Prefix:MR
First Name:LEONARDO
Middle Name:
Last Name:RAMIREZ
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:PO BOX 626
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0626
Mailing Address - Country:US
Mailing Address - Phone:787-834-3400
Mailing Address - Fax:787-805-5258
Practice Address - Street 1:169 MENDEZ VIGO ESTE
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-3400
Practice Address - Fax:787-805-5258
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR04160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist