Provider Demographics
NPI:1770331670
Name:RAMIREZ, TYNISHA M
Entity type:Individual
Prefix:
First Name:TYNISHA
Middle Name:M
Last Name:RAMIREZ
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:PO BOX 433
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-0433
Mailing Address - Country:US
Mailing Address - Phone:787-381-3091
Mailing Address - Fax:
Practice Address - Street 1:CARR. NO.2 KM 8.2 BO. JUAN SANCHEZ
Practice Address - Street 2:ANTIGUO HOSPITAL MEPSI CENTER
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960-7087
Practice Address - Country:US
Practice Address - Phone:787-763-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR168201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical