Provider Demographics
NPI:1497079727
Name:BADILLO RUIZ, MILITZA (MPT)
Entity Type:Individual
Prefix:
First Name:MILITZA
Middle Name:
Last Name:BADILLO RUIZ
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 57 BOX 9116
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9703
Mailing Address - Country:US
Mailing Address - Phone:787-593-5323
Mailing Address - Fax:787-868-7439
Practice Address - Street 1:HC 57 BOX 9116
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-9703
Practice Address - Country:US
Practice Address - Phone:787-593-5323
Practice Address - Fax:787-868-7439
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1397225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist