1336653880 NPI number — DR. JOSE A. NIEVES RAMIREZ MD

Table of content: DR. JOSE A. NIEVES RAMIREZ MD (NPI 1336653880)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336653880 NPI number — DR. JOSE A. NIEVES RAMIREZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NIEVES RAMIREZ
Provider First Name:
JOSE
Provider Middle Name:
A.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1336653880
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
O-17 CALLE 14
Provider Second Line Business Mailing Address:
URB VILLA RETIRO
Provider Business Mailing Address City Name:
SANTA ISABEL
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00757
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-412-4805
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 CALLE MATADERO SUR
Provider Second Line Business Practice Location Address:
CORPORACION PUERTORRIQUENA DE SALUD
Provider Business Practice Location Address City Name:
GURABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00778
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-653-5353
Provider Business Practice Location Address Fax Number:
787-653-5364
Provider Enumeration Date:
11/20/2017

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:  19800 , 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)