Healthcare Provider Details

I. General information

NPI: 1619021565
Provider Name (Legal Business Name): DR. MARILINDA RUIZ ACOSTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO. ANGELES
UTUADO PR
00641
US

IV. Provider business mailing address

3ER SECCION 30-73 PASEO CIPRES
LEVITOWN PR
00949
US

V. Phone/Fax

Practice location:
  • Phone: 787-894-1858
  • Fax: 787-894-1858
Mailing address:
  • Phone: 787-894-1858
  • Fax: 787-894-1858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number11953
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: