Provider Demographics
NPI:1932184645
Name:RUIZ, RAMON ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:ANTONIO
Last Name: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:PO BOX 293
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0293
Mailing Address - Country:US
Mailing Address - Phone:787-454-4173
Mailing Address - Fax:
Practice Address - Street 1:14 CALLE ROMA
Practice Address - Street 2:EXT. VILLA CAPARRA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-1705
Practice Address - Country:US
Practice Address - Phone:787-792-1325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8694207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR99806Medicare ID - Type Unspecified