Provider Demographics
NPI:1760459937
Name:RUIZ, ROSIBEL (DM)
Entity Type:Individual
Prefix:DR
First Name:ROSIBEL
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:DM
Other - Prefix:MRS
Other - First Name:DAMARYS
Other - Middle Name:
Other - Last Name:SALVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SECRETARY
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-0425
Mailing Address - Country:US
Mailing Address - Phone:787-894-1460
Mailing Address - Fax:
Practice Address - Street 1:27A CALLE BETANCES
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-2862
Practice Address - Country:US
Practice Address - Phone:787-894-1460
Practice Address - Fax:787-814-0546
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1270122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist