Healthcare Provider Details

I. General information

NPI: 1891754990
Provider Name (Legal Business Name): DANIEL ALFONSO RUIZ-SOLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STREET NUM 149 KM 63.8 EDIFICIO CRUZ SUITE 4 BO GUAYABAL
JUANA DIAZ PR
00795
US

IV. Provider business mailing address

1217 CALLE DON QUIJOTE COSTA CARIBE RESORT
PONCE PR
00716-2020
US

V. Phone/Fax

Practice location:
  • Phone: 787-837-5577
  • Fax: 787-837-5577
Mailing address:
  • Phone: 787-504-8229
  • Fax: 787-843-4362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number13922
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: