1164433595 NPI number — DR. HIRAM ANTONIO RUIZ MD

Table of content: DR. HIRAM ANTONIO RUIZ MD (NPI 1164433595)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164433595 NPI number — DR. HIRAM ANTONIO RUIZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUIZ
Provider First Name:
HIRAM
Provider Middle Name:
ANTONIO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RUIZ
Provider Other First Name:
HIRAM
Provider Other Middle Name:
ANTONIO
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M. D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1164433595
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1025
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00613-1025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-878-4849
Provider Business Mailing Address Fax Number:
787-878-7760

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CAYETANO COLL Y TOSTE SUITE 103
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-878-4849
Provider Business Practice Location Address Fax Number:
787-878-7760
Provider Enumeration Date:
08/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  3280 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)