Provider Demographics
NPI:1538606405
Name:RAMIREZ RAMIREZ, MARLENE (RD, LND)
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:RAMIREZ RAMIREZ
Suffix:
Gender:F
Credentials:RD, LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 8024
Mailing Address - Street 2:
Mailing Address - City:LAS MARIAS
Mailing Address - State:PR
Mailing Address - Zip Code:00670-9001
Mailing Address - Country:US
Mailing Address - Phone:787-662-5942
Mailing Address - Fax:
Practice Address - Street 1:399 AVE MUNOZ RIVERA
Practice Address - Street 2:LOCAL 105 B
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1614
Practice Address - Country:US
Practice Address - Phone:787-662-5942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1976133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal