Provider Demographics
NPI:1730743311
Name:RUIZ, DAMARIS MELISSA
Entity type:Individual
Prefix:
First Name:DAMARIS
Middle Name:MELISSA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PRADERAS DE NAVARRO
Mailing Address - Street 2:214 Q11 JACINTO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-640-0372
Mailing Address - Fax:
Practice Address - Street 1:AVE LUIS MUNOZ MARIN SANTA JUANA
Practice Address - Street 2:EDIFICIO MERCANTIL
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-746-2010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1074208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation