MEDICARE: DR. ANA T QULIES RUIZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	9948	PR

General Provider Information

NPI Number	:	1235112368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANA T QULIES RUIZ MD

Provider Business Mailing Address
First Line	:	823 CAMINO EL GUAYO
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00680-8117
Country	:	US
Telephone Number	:	787-834-2691
Fax Number	:

Provider Business Practice Location Address
First Line	:	EDIF MULTIFABRIL OFIC 201
Second Line	:
City	:	HORMIGUEROS
State	:	PR
Zip	:	00660
Country	:	US
Telephone Number	:	787-834-2691
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	07/09/2007

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