Healthcare Provider Details

I. General information

NPI: 1578038410
Provider Name (Legal Business Name): YEROLINE ZENNETTE RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2018
Last Update Date: 10/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 CALLE MAGA ESTANCIAS MONTE RIO
CAYEY PR
00737-9696
US

IV. Provider business mailing address

133 CALLE MAGA ESTANCIAS MONTE RIO
CAYEY PR
00737
US

V. Phone/Fax

Practice location:
  • Phone: 787-241-7083
  • Fax:
Mailing address:
  • Phone: 787-241-7083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: