Provider Demographics
NPI:1356217418
Name:RUIZ DELGADO, JEREMY YESIEL
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:YESIEL
Last Name:RUIZ DELGADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 AVE MUNOZ RIVERA E
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-2628
Mailing Address - Country:US
Mailing Address - Phone:787-243-5930
Mailing Address - Fax:
Practice Address - Street 1:16 AVE MUNOZ RIVERA E
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-2628
Practice Address - Country:US
Practice Address - Phone:787-243-5930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program