Provider Demographics
NPI:1083895684
Name:DONATO-RUIZ, ZAHIDEE LIZ
Entity Type:Individual
Prefix:
First Name:ZAHIDEE
Middle Name:LIZ
Last Name:DONATO-RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 CALLE ESTRELLA
Mailing Address - Street 2:URB ALTURAS DE SAN BENITO
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3755
Mailing Address - Country:US
Mailing Address - Phone:787-914-1835
Mailing Address - Fax:
Practice Address - Street 1:AVE. FIDALGO DIAZ
Practice Address - Street 2:ESQ VIA JOSEFINA 4SS6 VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-776-3511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR599231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRFJ523ZMedicare PIN