Provider Demographics
NPI:1053764720
Name:RAMIREZ MALAVE, JUAN G (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:G
Last Name:RAMIREZ MALAVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAYAMON MEDICAL MALL
Mailing Address - Street 2:SUITE 307
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-7200
Mailing Address - Country:US
Mailing Address - Phone:787-787-3535
Mailing Address - Fax:
Practice Address - Street 1:BAYAMON MEDICAL MALL OFC
Practice Address - Street 2:SUITE 307
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7200
Practice Address - Country:US
Practice Address - Phone:787-787-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-19
Last Update Date:2020-10-02
Deactivation Date:2020-09-08
Deactivation Code:
Reactivation Date:2020-10-02
Provider Licenses
StateLicense IDTaxonomies
PR19434208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice