Basic Information
Provider Information | |||||||||
NPI: | 1528320728 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ARRIBAS-CRUZ | ||||||||
FirstName: | RICARDO | ||||||||
MiddleName: | LUIS | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 871 CALLE SGTO GERARDO SANTIAGO | ||||||||
Address2: | CARRETERA #14 INTERIOR | ||||||||
City: | AIBONITO | ||||||||
State: | PR | ||||||||
PostalCode: | 00705 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7877142462 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | CALLE SGTO GERARDO SANTIAGO | ||||||||
Address2: | CARRETERA #14 INTERIOR | ||||||||
City: | AIBONITO | ||||||||
State: | PR | ||||||||
PostalCode: | 00705 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7877142462 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/13/2012 | ||||||||
LastUpdateDate: | 03/17/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 19339 | PR | Y |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.