Healthcare Provider Details

I. General information

NPI: 1346417565
Provider Name (Legal Business Name): HECTOR L RUIZ MEDICAL TECHNOLOGIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 08/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CALLE ANTONIO R BARCELO
MAUNABO PR
00707-2141
US

IV. Provider business mailing address

21 CALLE ANTONIO R BARCELO
MAUNABO PR
00707-2141
US

V. Phone/Fax

Practice location:
  • Phone: 787-861-0100
  • Fax:
Mailing address:
  • Phone: 787-861-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number1459
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: