Provider Demographics
NPI:1194332494
Name:RUIZ NUNEZ, VANESSA I (MD)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:I
Last Name:RUIZ NUNEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB SAN JOSE
Mailing Address - Street 2:42 CALLE B
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-3131
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:URB SAN JOSE
Practice Address - Street 2:42 CALLE B
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3131
Practice Address - Country:US
Practice Address - Phone:787-806-7735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21986208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice