Provider Demographics
NPI:1114992708
Name:RUIZ-CALES, JOSE JAVIER (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:JAVIER
Last Name:RUIZ-CALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LOS CANTIZALES APT A104
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2574
Mailing Address - Country:US
Mailing Address - Phone:787-344-5560
Mailing Address - Fax:
Practice Address - Street 1:AVE. LOS FILTROS ENTRADA AMERICAN MILITARY ACADEMY
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-789-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9879207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1755222201Medicaid
TXI20977Medicare UPIN
TX1755222201Medicaid