Provider Demographics
NPI:1346312931
Name:MATOS RUIZ, NELSON FELIPE (MD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:FELIPE
Last Name:MATOS 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:PO BOX 3049
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-3049
Mailing Address - Country:US
Mailing Address - Phone:787-785-8034
Mailing Address - Fax:
Practice Address - Street 1:COND GALLARDO TOWERS
Practice Address - Street 2:OFICINA 201
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-785-8034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR147432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology