Provider Demographics
NPI:1558403501
Name:RUIZ, LUZ A (RD)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:A
Last Name:RUIZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8975
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910-0975
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:787-756-8529
Practice Address - Street 1:ING C GALINDE CPRS LOBBY
Practice Address - Street 2:TERRENOS DE CENTRO MEDICO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-0001
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:787-756-8529
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1096133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered