Provider Demographics
NPI:1669634762
Name:RUIZ, ALERIZ
Entity Type:Individual
Prefix:
First Name:ALERIZ
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 AVE GUARICO
Mailing Address - Street 2:PO BOX 2029 VEGA BAJA, PR 00694
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-4014
Mailing Address - Country:US
Mailing Address - Phone:787-210-9891
Mailing Address - Fax:787-871-3122
Practice Address - Street 1:CARR 149 KM 9.8 BO CAMPAMENTO
Practice Address - Street 2:
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638
Practice Address - Country:US
Practice Address - Phone:787-871-3105
Practice Address - Fax:787-871-3122
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7204183700000X, 247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other