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General NPI Number Information
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NPI Number | 1356380455
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Entity Type | Individual
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Provider Name | LYDIA I RUIZ MUNIZ MD
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Gender | Female
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 07/08/2020
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Provider Practice Location Address
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Address Line | CAROLINA SHOPP CTR PRIMER NIVEL SUITE 7
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City | CAROLINA
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State | PR
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Zip | 00985-5672
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Country | US
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Telephone | 787-768-0120
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Fax | 787-768-0120
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Provider Business Mailing Address
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Address Line | URB. VILLA ANTILLANA AN-32 PLAZA SAN VICENTE
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976
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Country | US
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Telephone | 787-646-1394
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Fax | 787-768-0120
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 9612
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License Number State | PR
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