Provider Demographics
NPI:1245109651
Name:RUIZ MARTINEZ, NATASHA (LIC)
Entity type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:
Last Name:RUIZ MARTINEZ
Suffix:
Gender:F
Credentials:LIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 CALLE BONET
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-7440
Mailing Address - Country:US
Mailing Address - Phone:787-202-5655
Mailing Address - Fax:
Practice Address - Street 1:329 CAMINO BONET BO. MIRADERO
Practice Address - Street 2:BO. MIRADERO
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682
Practice Address - Country:US
Practice Address - Phone:787-202-5655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR173421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty