Provider Demographics
NPI:1164458246
Name:MEJIAS RUIZ, ISMAEL (MD)
Entity Type:Individual
Prefix:
First Name:ISMAEL
Middle Name:
Last Name:MEJIAS RUIZ
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:COND. PASEO MONTES APT. 611
Mailing Address - Street 2:AVE. FELISA RINCON #381
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-366-9083
Mailing Address - Fax:
Practice Address - Street 1:COND. PASEO MONTES APT. 611
Practice Address - Street 2:AVE. FELISA RINCON #381
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-366-9083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15319207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine