Basic Information
Provider Information
NPI: 1144677196
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRACIA RAMIS
FirstName: ALVARO
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2116
Address2:  
City: SAN JUAN
State: PR
PostalCode: 009222116
CountryCode: US
TelephoneNumber: 7877540101
FaxNumber:  
Practice Location
Address1: UNIVERSITY DISTRICT HOSPITAL PUERTO RICO MEDICAL CENTER
Address2: BO. MONACILLOS
City: SAN JUAN
State: PR
PostalCode: 009350001
CountryCode: US
TelephoneNumber: 7877540101
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/19/2016
LastUpdateDate: 04/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X34318PRY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


Home