Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | 16253020 | WI |
Y | 207RI0200X | Infectious Disease | 2657 | PR |
NPI | 1063598266 |
---|---|
Provider Name | Dr. Ramon H Bermudez-Del Valle |
First Address | Guaynabo, PR 00970-1737 |
Second Address | San Juan, PR 00919-1227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 22/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10391 | HUMANA (01) | |
234020 | PREFERRED HEALTH (01) | |
66040 | MAPPRE (01) | |
E31058 | (02) |