Basic Information
| Provider Information | |||||||||
| NPI: | 1790860120 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMIREZ SCHON | ||||||||
| FirstName: | THEMISTOCLES | ||||||||
| MiddleName: | JULIAN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 68 | ||||||||
| Address2: | |||||||||
| City: | MAYAGUEZ | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878325333 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | CALLE DR. RAMON EMETERIO BETANCES #18 NORTE | ||||||||
| Address2: | |||||||||
| City: | MAYAGUEZ | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006810000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878340050 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2006 | ||||||||
| LastUpdateDate: | 08/21/2014 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0106X | 2832 | PR | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | 207XX0801X | 2832 | PR | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma |
ID Information
| ID | Type | State | Issuer | Description | 064732 | 01 | BLUE CROSS | OTHER | 20000598 | 01 | ACAA | OTHER | 7090024 | 01 | HUMANA | OTHER | 9513 | 01 | SERVI MEDICAL | OTHER | 32832 | 01 | MED CARD SYSTEM | OTHER | 8094 | 01 | INTL MEDICAL CARE | OTHER | RA94845 | 01 | TRIPLE S | OTHER | 202025 | 01 | PREFERRED HEALTH | OTHER | 402832 | 01 | QIA | OTHER |