Provider Demographics
NPI:1396590758
Name:RUIZ NARDONE, ALEXANDRA M (DPT)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:M
Last Name:RUIZ NARDONE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:M
Other - Last Name:RUIZ NARDONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:CONDOMINIO CAPARRA CHALET 49 CALLE 8
Mailing Address - Street 2:APT 19
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-1771
Mailing Address - Country:US
Mailing Address - Phone:787-330-2100
Mailing Address - Fax:
Practice Address - Street 1:E6 CALLE SANTA CRUZ
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6905
Practice Address - Country:US
Practice Address - Phone:787-330-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4642225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist