Healthcare Provider Details

I. General information

NPI: 1053239228
Provider Name (Legal Business Name): MARIELI RUIZ CORTES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 423 KM 4.0 BO PLATA
MOCA PR
00676
US

IV. Provider business mailing address

PO BOX 1769
MOCA PR
00676-1769
US

V. Phone/Fax

Practice location:
  • Phone: 787-597-1244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number48791
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: