Provider Demographics
NPI:1245288174
Name:RUIZ-RODRIGUEZ, JAIME FRANCISCO (MD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:FRANCISCO
Last Name:RUIZ-RODRIGUEZ
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 805
Mailing Address - Street 2:
Mailing Address - City:SAINT JUST
Mailing Address - State:PR
Mailing Address - Zip Code:00978-0805
Mailing Address - Country:US
Mailing Address - Phone:787-705-8924
Mailing Address - Fax:787-705-8923
Practice Address - Street 1:1801 AVE PONCE DE LEON
Practice Address - Street 2:SUITE 405
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1900
Practice Address - Country:US
Practice Address - Phone:787-705-8924
Practice Address - Fax:787-705-8923
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR007145174400000X
PR7145207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD26739Medicare UPIN
PR0028028KMedicare ID - Type UnspecifiedCARDIOLOGIST