Provider Demographics
NPI:1215950985
Name:RUIZ DIAZ, JORGE E (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:E
Last Name:RUIZ DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 989
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-0989
Mailing Address - Country:US
Mailing Address - Phone:787-829-1096
Mailing Address - Fax:787-829-0251
Practice Address - Street 1:10A RIUS RIVERA
Practice Address - Street 2:
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601
Practice Address - Country:US
Practice Address - Phone:787-829-1096
Practice Address - Fax:787-809-0251
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR8316207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8316OtherMEDICAL LICENSE