Healthcare Provider Details

I. General information

NPI: 1770638314
Provider Name (Legal Business Name): RUBEN GALARZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LUIS MUNOZ RIVERA 307
PENUELAS PR
00624
US

IV. Provider business mailing address

PO BOX 24
YAUCO PR
00698-0024
US

V. Phone/Fax

Practice location:
  • Phone: 787-836-2903
  • Fax: 787-836-4298
Mailing address:
  • Phone: 787-836-2903
  • Fax: 787-836-4298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4800
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: