Provider Demographics
NPI:1164671285
Name:RUIZ-ACEVEDO, ILIANETTE (MD)
Entity Type:Individual
Prefix:
First Name:ILIANETTE
Middle Name:
Last Name:RUIZ-ACEVEDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 CALLE COLON
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-3105
Mailing Address - Country:US
Mailing Address - Phone:787-546-0461
Mailing Address - Fax:787-252-0436
Practice Address - Street 1:90 CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3105
Practice Address - Country:US
Practice Address - Phone:787-546-0461
Practice Address - Fax:787-252-0436
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR203892084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry