1194173252 NPI number — DR. NICOLE MARIE DIAZ-RAMOS MD

Table of content: DR. NICOLE MARIE DIAZ-RAMOS MD (NPI 1194173252)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194173252 NPI number — DR. NICOLE MARIE DIAZ-RAMOS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DIAZ-RAMOS
Provider First Name:
NICOLE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1194173252
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BARRIO MONACILLOS CARR. 22, CENTRO MEDICO
Provider Second Line Business Mailing Address:
HOSPITAL PEDIATRICO UNIVERSITARIO DR. ANTONIO ORTIZ
Provider Business Mailing Address City Name:
RIO PIEDRAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00935
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-753-6390
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
METROPOLITAN HOSPITAL DR. SUSONI
Provider Second Line Business Practice Location Address:
#55 CALLE PALMA
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-539-3554
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2016

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: 208000000X , with the licence number:  21241 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207K00000X , with the licence number: 21241 , 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)





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