1659497345 NPI number — MR. JAVIER ENRIQUE RAMIREZ OPTICO

Table of content: MR. JAVIER ENRIQUE RAMIREZ OPTICO (NPI 1659497345)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659497345 NPI number — MR. JAVIER ENRIQUE RAMIREZ OPTICO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMIREZ
Provider First Name:
JAVIER
Provider Middle Name:
ENRIQUE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
OPTICO
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:
1659497345
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/26/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 227
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAJAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00667-0227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-899-1800
Provider Business Mailing Address Fax Number:
787-899-1800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
JOSE M. TORO
Provider Second Line Business Practice Location Address:
BASORA # 4
Provider Business Practice Location Address City Name:
LAJAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00667
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-899-1800
Provider Business Practice Location Address Fax Number:
787-899-1800
Provider Enumeration Date:
03/22/2007

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: 156FX1800X , with the licence number:  224 , 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: 100259 . This is a "CRUZ AZUL DE PUERTO RICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 8078 . This is a "FIRST MEDICAL CARD" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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