Healthcare Provider Details

I. General information

NPI: 1265805295
Provider Name (Legal Business Name): VICTOR RUIZ-GARCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2015
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 3356 KM 1 BO BATEYES
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

PO BOX 1567
MAYAGUEZ PR
00681
US

V. Phone/Fax

Practice location:
  • Phone: 787-718-2747
  • Fax:
Mailing address:
  • Phone: 787-718-2747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19189
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number19189
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: