Provider Demographics
NPI:1134298920
Name:FAMILY HEALTH GROUP S.S.C.S.P
Entity Type:Organization
Organization Name:FAMILY HEALTH GROUP S.S.C.S.P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MWEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ-MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-280-3074
Mailing Address - Street 1:PO BOX 5446
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-5446
Mailing Address - Country:US
Mailing Address - Phone:787-280-3074
Mailing Address - Fax:
Practice Address - Street 1:AVE. EMERITO ESTRADA RIVERA
Practice Address - Street 2:SUITE 901
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-280-3074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR991358OtherPREFERRED MEDICARE CHOICE
PR00385OtherAMERICAN HEALTH PLAN
RI996208OtherMEDICARE Y MUCHO MAS
RI996208OtherMEDICARE Y MUCHO MAS
PR=========OtherMEDICAL CARD SYSTEM
PR=========OtherMCSCLASSICARE