1952506974 NPI number — MR. RAUL RODRIGUEZ RUIZ PHYSICAL THERAPIST

Table of content: MR. RAUL RODRIGUEZ RUIZ PHYSICAL THERAPIST (NPI 1952506974)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952506974 NPI number — MR. RAUL RODRIGUEZ RUIZ PHYSICAL THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUIZ
Provider First Name:
RAUL
Provider Middle Name:
RODRIGUEZ
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPIST
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:
1952506974
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 21420
Provider Second Line Business Mailing Address:
UPR STATION
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00931-1420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-752-7505
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
217 CLAVEL ST.
Provider Second Line Business Practice Location Address:
BUZON 632 BO. BUENAVENTURA
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00987
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-752-7505
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/19/2007

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: 225100000X , with the licence number:  481 , 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)





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