Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 22431 | PR |
NPI | 1003489774 |
---|---|
Provider Name | Dr. Cristina Melisa Ramos Malave |
First Address | Cidra, PR 00739-1609 |
Second Address | Aibonito, PR 00705-3304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2021 |
Last Update Date | 12/10/2021 |