Provider Demographics
NPI:1982652889
Name:RODRIGUEZ-RUIZ, JOSE A (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:A
Last Name:RODRIGUEZ-RUIZ
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 1:274 ST PBI COUNTRY CLUB
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982-2768
Mailing Address - Country:US
Mailing Address - Phone:787-769-2262
Mailing Address - Fax:787-768-5577
Practice Address - Street 1:274 ST PBI COUNTRY CLUB
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2768
Practice Address - Country:US
Practice Address - Phone:787-769-2262
Practice Address - Fax:787-768-5577
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2763207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5130997OtherFEDERAL DRUG IDENTIFIER N
C18069Medicare UPIN
5130997OtherFEDERAL DRUG IDENTIFIER N