1538456546 NPI number — DR. NELSON RUIZ-FEBO DMD

Table of content: DR. NELSON RUIZ-FEBO DMD (NPI 1538456546)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538456546 NPI number — DR. NELSON RUIZ-FEBO DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUIZ-FEBO
Provider First Name:
NELSON
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538456546
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB.EL MIRADOR DE CUPEY A-6 CALLE 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926-7545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-460-0283
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VILLA DEL ROSARIO CALLE 2 A-3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAGUABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00781
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-460-0283
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/29/2011

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: 1223X0400X , with the licence number:  10173 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223X0400X , with the licence number: 3150 , 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)