Provider Demographics
NPI:1508909649
Name:RUIZ, MELVIN (DC)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:
Last Name:RUIZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NN8 CALLE CANGREJO
Mailing Address - Street 2:DORADO DEL MAR
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-2326
Mailing Address - Country:US
Mailing Address - Phone:787-278-3673
Mailing Address - Fax:
Practice Address - Street 1:19 MARIA CADILLA ST.
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-878-4408
Practice Address - Fax:787-278-3673
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7-2574Medicare UPIN
PR35032Medicare ID - Type Unspecified