Provider Demographics
NPI:1053176750
Name:RAMOS JIMENEZ, CORALIS (PHARMD)
Entity type:Individual
Prefix:
First Name:CORALIS
Middle Name:
Last Name:RAMOS JIMENEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 7 BOX 39164
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-9239
Mailing Address - Country:US
Mailing Address - Phone:787-673-0176
Mailing Address - Fax:
Practice Address - Street 1:202 AVE LA MOCA
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-4012
Practice Address - Country:US
Practice Address - Phone:787-877-2216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH18943183500000X
PR008215183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist