Provider Demographics
NPI:1407396179
Name:CARLOS E RUIZ RODRIGUEZ MD LLC
Entity Type:Organization
Organization Name:CARLOS E RUIZ RODRIGUEZ MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:E
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-528-0937
Mailing Address - Street 1:J2 CALLE CLUB DR
Mailing Address - Street 2:URB GARDEN HILL NORTE
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2121
Mailing Address - Country:US
Mailing Address - Phone:787-528-0937
Mailing Address - Fax:
Practice Address - Street 1:150 AVE DE DIEGO STE 300
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-2322
Practice Address - Country:US
Practice Address - Phone:787-729-0606
Practice Address - Fax:787-729-4242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13406207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty