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General NPI Number Information
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NPI Number | 1881679298
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Entity Type | Individual
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Provider Name | IGNACIO CORADIN RUIZ MD
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Gender | Male
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Dates
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Enumeration Date | 12/08/2005
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | NAGUABO MEDICAL MALL CARR 31 KM 4.0
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City | NAGUABO
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State | PR
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Zip | 00718-0001
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Country | US
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Telephone | 787-874-3152
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Fax | 787-874-3125
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Provider Business Mailing Address
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Address Line | 2048 FERNANDO DE ROJAS URB EL SENORIAL
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City | SAN JUAN
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State | PR
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Zip | 00926-6929
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Country | US
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Telephone | 939-456-4787
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Fax | 787-874-3125
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11535
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License Number State | PR
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