Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 4481 | PR |
NPI | 1548282379 |
---|---|
Provider Name | Dr. Jose H Ruiz |
First Address | Guaynabo, PR 00970-3916 |
Second Address | Aibonito, PR 00705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4481 | PUERTO RICO MD LICENSE (01) | PR |