Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 697 | PR |
NPI | 1003151267 |
---|---|
Provider Name | Miss Roselyn Enid Ramirez Cruz |
First Address | San Juan, PR 00901-2472 |
Second Address | San Juan, PR 00901-2472 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2012 |
Last Update Date | 26/12/2019 |