1801964424 NPI number — DR. WILMER LUGO RAMIREZ M.D.

Table of content: DR. WILMER LUGO RAMIREZ M.D. (NPI 1801964424)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801964424 NPI number — DR. WILMER LUGO RAMIREZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMIREZ
Provider First Name:
WILMER
Provider Middle Name:
LUGO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801964424
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 851
Provider Second Line Business Mailing Address:
PMB 341
Provider Business Mailing Address City Name:
HUMACAO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00792-0851
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-285-5558
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
170 AVE. FONT MARTELO
Provider Second Line Business Practice Location Address:
BAJOS
Provider Business Practice Location Address City Name:
HUMACAO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00791-3765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-285-5558
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  10748 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0519 . This is a "IMC" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1761 . This is a "AMERICAN HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6230050 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 83186 . This is a "SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 36921 . This is a "PROSAM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 069917 . This is a "CRUZ AZUL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 200340 . This is a "PREFERED HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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