Healthcare Provider Details

I. General information

NPI: 1437265410
Provider Name (Legal Business Name): D'CORPO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 URB CATALANA
BARCELONETA PR
00617-2774
US

IV. Provider business mailing address

PO BOX 419
BARCELONETA PR
00617-0419
US

V. Phone/Fax

Practice location:
  • Phone: 787-846-5553
  • Fax: 787-846-5554
Mailing address:
  • Phone: 787-846-5553
  • Fax: 787-846-5554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: POLLY A RUIZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-846-5553