Provider Demographics
NPI:1467975557
Name:RUIZ, SAUL SR (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:SAUL
Middle Name:
Last Name:RUIZ
Suffix:SR
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 7574
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-9762
Mailing Address - Country:US
Mailing Address - Phone:787-690-6295
Mailing Address - Fax:
Practice Address - Street 1:CARR 185 KM. 6.1 BO. CAMPO RICO
Practice Address - Street 2:
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-9762
Practice Address - Country:US
Practice Address - Phone:787-690-6295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR548156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician