Provider Demographics
NPI:1770638314
Name:GALARZA, RUBEN (MD)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:GALARZA
Suffix:
Gender:M
Credentials:MD
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 24
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-0024
Mailing Address - Country:US
Mailing Address - Phone:787-836-2903
Mailing Address - Fax:787-836-4298
Practice Address - Street 1:LUIS MUNOZ RIVERA
Practice Address - Street 2:307
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624
Practice Address - Country:US
Practice Address - Phone:787-836-2903
Practice Address - Fax:787-836-4298
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4800208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR203740OtherMEDICAL PLAN
PR02693OtherMEDICAL PLAN
PR7682035OtherMEDICAL PLAN
PR3-4800OtherMEDICAL PLAN
PR25561OtherMEDICAL PLAN
PR2693OtherMEDICAL PLAN
PR25861OtherMEDICAL PLAN
PR4104800OtherMEDICAL PLAN
PRSE4534OtherMEDICAL PLAN
PR06526OtherMEDICAL PLAN