Healthcare Provider Details

I. General information

NPI: 1659287050
Provider Name (Legal Business Name): ENILEDAM ASHKYR RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO COTO CARR 474 KM 0.5 FELIPE MENDEZ NUM 10
ISABELA PR
00662
US

IV. Provider business mailing address

3006 HACIENDA LA QUINTA
ISABELA PR
00662
US

V. Phone/Fax

Practice location:
  • Phone: 787-872-8162
  • Fax:
Mailing address:
  • Phone: 787-974-1191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number81473
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: