Healthcare Provider Details

I. General information

NPI: 1568923118
Provider Name (Legal Business Name): DANIEL ERNESTO REYES-RUIZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO MEDICO CARRETERA 22 UNIVERSITY PEDIATRIC HOSPITAL
SAN JUAN PR
00936
US

IV. Provider business mailing address

PO BOX 360361
SAN JUAN PR
00936-0361
US

V. Phone/Fax

Practice location:
  • Phone: 210-704-3939
  • Fax:
Mailing address:
  • Phone: 787-427-5258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number023197
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number023197
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: