Provider Demographics
NPI:1497902316
Name:RUIZ- LORENZO, YAMILCIS JENOURY (MD)
Entity Type:Individual
Prefix:
First Name:YAMILCIS
Middle Name:JENOURY
Last Name:RUIZ- LORENZO
Suffix:
Gender:F
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:HC 56 BOX 34286-1
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9773
Mailing Address - Country:US
Mailing Address - Phone:787-464-0903
Mailing Address - Fax:
Practice Address - Street 1:2225 PONCE BY PASS STE 302
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1322
Practice Address - Country:US
Practice Address - Phone:787-844-1248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16077207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine