Healthcare Provider Details

I. General information

NPI: 1821920554
Provider Name (Legal Business Name): JANNE RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANNE MARIE VAZQUEZ VEGA

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE SOTO ALMODOVAR #4A PUEBLO NUEVO
SABANA GRANDE PR
00637
US

IV. Provider business mailing address

CALLE SOTO ALMODOVAR #4A PUEBLO NUEVO
SABANA GRANDE PR
00637
US

V. Phone/Fax

Practice location:
  • Phone: 787-400-6000
  • Fax:
Mailing address:
  • Phone: 787-400-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-503042
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: