Provider Demographics
NPI:1295768604
Name:RUIZ ABURTO, JAVIER (MD, FACS, FICS)
Entity type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:
Last Name:RUIZ ABURTO
Suffix:
Gender:M
Credentials:MD, FACS, FICS
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 336006
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733-6006
Mailing Address - Country:US
Mailing Address - Phone:787-840-7084
Mailing Address - Fax:787-813-0908
Practice Address - Street 1:623 ROVIRA OFFICE PARK
Practice Address - Street 2:CUATRO CALLE AVENUE SUITE 303
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1902
Practice Address - Country:US
Practice Address - Phone:787-840-7084
Practice Address - Fax:787-813-0908
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR105802086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Not Answered208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR363OtherCRUZ AZUL
D65800Medicare UPIN
82883Medicare ID - Type Unspecified