Basic Information
| Provider Information | |||||||||
| NPI: | 1548282379 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUIZ | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3916 | ||||||||
| Address2: | |||||||||
| City: | GUAYNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009703916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879990753 | ||||||||
| FaxNumber: | 7879990790 | ||||||||
| Practice Location | |||||||||
| Address1: | CALLE STANLEY MILLER 11 | ||||||||
| Address2: | BO CAONILLA | ||||||||
| City: | AIBONITO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877355060 | ||||||||
| FaxNumber: | 7877355060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PP0204X | 4481 | PR | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Pediatric Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 4481 | 01 | PR | PUERTO RICO MD LICENSE | OTHER |