Healthcare Provider Details

I. General information

NPI: 1578506937
Provider Name (Legal Business Name): OSCAR A RUIZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AVE. F.D ROOSEVELT SUITE 410
HATO REY PR
00918
US

IV. Provider business mailing address

400 AVE. F.D ROOSEVELT SUITE 410
HATO REY PR
00918
US

V. Phone/Fax

Practice location:
  • Phone: 787-753-6414
  • Fax: 787-763-7125
Mailing address:
  • Phone: 787-753-6414
  • Fax: 787-763-7125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number6760
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: