Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 28375 | PR |
N | 111NI0900X | Internist | 28375 | PR |
N | 2084V0102X | Vascular Neurology | 2020038636 | MO |
N | 2084V0102X | Vascular Neurology | ME132375 | FL |
NPI | 1003194549 |
---|---|
Provider Name | Juan C Ramos-Canseco |
First Address | West Palm Beach, FL 33407-2413 |
Second Address | West Palm Beach, FL 33407-2413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2011 |
Last Update Date | 17/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2020038636 | MO STATE MEDICAL BOARD (01) | MO |
28375 | PUERTO RICO RESIDENT LISCENCE (01) | PR |
ME624 | FL MEDICARE (01) | FL |