Basic Information
| Provider Information | |||||||||
| NPI: | 1003151267 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMIREZ CRUZ | ||||||||
| FirstName: | ROSELYN | ||||||||
| MiddleName: | ENID | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 AVE MUNOZ RIVERA APT 615 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009012472 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9397177573 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 25 AVE MUNOZ RIVERA APT 615 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009012472 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9397177573 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2012 | ||||||||
| LastUpdateDate: | 12/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/26/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 697 | PR | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.