MEDICARE: SONIA RUIZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	4186	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SR4186	OTHER	PR	PHARMACIST

General Provider Information

NPI Number	:	1447890223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA RUIZ

Provider Business Mailing Address
First Line	:	48-13 CALLE 40
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00985-5524
Country	:	US
Telephone Number	:	787-810-1646
Fax Number	:

Provider Business Practice Location Address
First Line	:	K628 AVE JORGE VAZQUEZ SANES
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00983-1402
Country	:	US
Telephone Number	:	787-768-6637
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2020
Last Update Date	:	01/09/2020

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Directions to “ SONIA RUIZ ” Practice Location

Language	Start Address	Practice Location

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