MEDICARE: MR. RAFAEL RUIZ DE LA UZ 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	207R00000X	Internal Medicine Physician	11968	PR

General Provider Information

NPI Number	:	1689630485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RAFAEL RUIZ DE LA UZ MD

Provider Business Mailing Address
First Line	:	CARIMED PLAZA SUITE 401
Second Line	:	B1 CALLE SANTA CRUZ
City	:	BAYAMON
State	:	PR
Zip	:	00961-6933
Country	:	US
Telephone Number	:	787-269-2585
Fax Number	:	787-269-2552

Provider Business Practice Location Address
First Line	:	B1 CALLE SANTA CRUZ STE 401
Second Line	:	B1 CALLE SANTA CRUZ
City	:	BAYAMON
State	:	PR
Zip	:	00961-6945
Country	:	US
Telephone Number	:	787-269-2585
Fax Number	:	787-269-2552

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

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	03/21/2013

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