Provider Demographics
NPI:1639232705
Name:RUIZ, NIMSY (DMD)
Entity Type:Individual
Prefix:
First Name:NIMSY
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LAS HACIENDAS 15043 CALLE CAMINO LARGO
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-438-2186
Mailing Address - Fax:
Practice Address - Street 1:CAROLINA SHOPP CTR STE 311
Practice Address - Street 2:AVE 65TH INF ESQ ROBERTO CLEMENTE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5672
Practice Address - Country:US
Practice Address - Phone:787-512-0488
Practice Address - Fax:787-752-0332
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice