Provider Demographics
NPI:1093101230
Name:NAVARRO-SANTOS, RUTHSARY
Entity Type:Individual
Prefix:
First Name:RUTHSARY
Middle Name:
Last Name:NAVARRO-SANTOS
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 1:14 CALLE B
Mailing Address - Street 2:RODRIGUEZ OLMO
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-4221
Mailing Address - Country:US
Mailing Address - Phone:787-940-6254
Mailing Address - Fax:
Practice Address - Street 1:B1 CALLE 3
Practice Address - Street 2:REPARTO MARQUEZ
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-940-6254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3014235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist