Provider Demographics
NPI:1386848331
Name:RUIZ, NYDIA (CRNA)
Entity Type:Individual
Prefix:
First Name:NYDIA
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FIDEL CASTILLO #55
Mailing Address - Street 2:EL SECO
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682
Mailing Address - Country:US
Mailing Address - Phone:787-831-5994
Mailing Address - Fax:787-834-1919
Practice Address - Street 1:FIDEL CASTILLO #55
Practice Address - Street 2:EL SECO
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682
Practice Address - Country:US
Practice Address - Phone:787-831-5994
Practice Address - Fax:787-834-1919
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR513163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR513OtherPROFESSIONAL LICENSE