Provider Demographics
NPI:1629284310
Name:RUIZ-RODRIGUEZ, CARMINA M (MD)
Entity Type:Individual
Prefix:DR
First Name:CARMINA
Middle Name:M
Last Name:RUIZ-RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7196
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7196
Mailing Address - Country:US
Mailing Address - Phone:787-258-6063
Mailing Address - Fax:787-258-6063
Practice Address - Street 1:CONSOLIDATED MALL SUITE C-33 D
Practice Address - Street 2:AVE. GAUTIER BENITEZ
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-745-2510
Practice Address - Fax:787-745-2510
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR11514207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG-41697Medicare UPIN