Provider Demographics
NPI:1104901099
Name:MAISONET, RUTH NOEMI (MD)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:NOEMI
Last Name:MAISONET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RUTH
Other - Middle Name:N
Other - Last Name:MAISONET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MDFACOG
Mailing Address - Street 1:PMB 327 PO BOX 70344
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:UM
Mailing Address - Phone:787-292-0424
Mailing Address - Fax:787-282-0869
Practice Address - Street 1:C/RVDO DOMINGO MARRERO NAVARRO NUM 4
Practice Address - Street 2:URB STA RITA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925
Practice Address - Country:US
Practice Address - Phone:787-765-2003
Practice Address - Fax:787-282-0869
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12585207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology