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General NPI Number Information
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NPI Number | 1154954170
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Entity Type | Individual
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Provider Name | CARLOS MANUEL LEON RUIZ
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Gender | Male
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Dates
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Enumeration Date | 02/18/2020
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 400 AVE LUIS MUNOZ RIVERA
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City | SAN JUAN
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State | PR
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Zip | 00918-3310
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Country | US
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Telephone | 787-296-8460
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Fax |
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Provider Business Mailing Address
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Address Line | 385 COND VALLES DE TORRIMAR
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 909-362-2961
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6749
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License Number State | PR
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