Individual provider Active NPI

Lilliam Mabel Ramos Olivencia, M.D.

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1982692075
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
8304 Issued in PR
Practice address
2225 Ponce by Pass
Suite 501
Ponce, PR 00717-1321
Phone
(787) 843-9110
Fax
(787) 259-2195
NPI assigned
Oct 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 8304 PR Primary

Addresses

Primary practice location

2225 Ponce by Pass
Suite 501
Ponce, PR 00717-1321

Mailing address

2225 Ponce by Pass
Suite 501
Ponce, PR 00717-1368
Phone (787) 843-9110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8304PRMDGeneral Practice Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982692075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 PONCE BY PASS",
            "address_2": "SUITE 501",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171368",
            "telephone_number": "787-843-9110",
            "fax_number": "787-259-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 PONCE BY PASS",
            "address_2": "SUITE 501",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171321",
            "telephone_number": "787-843-9110",
            "fax_number": "787-259-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS OLIVENCIA",
        "first_name": "LILLIAM",
        "middle_name": "MABEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "8304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.