Provider Demographics
NPI:1609491927
Name:ELVIR RAMOS, LILLIAN KARINA
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:KARINA
Last Name:ELVIR RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4LS12 VIA LETICIA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-4823
Mailing Address - Country:US
Mailing Address - Phone:787-752-4950
Mailing Address - Fax:
Practice Address - Street 1:4LS12 VIA LETICIA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-4823
Practice Address - Country:US
Practice Address - Phone:787-752-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR34121223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6446985OtherDRIVERS LICENSE