Provider Demographics
NPI:1427162445
Name:RUIZ MEDINA, HELEN (MD)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:RUIZ MEDINA
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:HC9 BOX 17062 BO RIO CHIQUITO KM 2 HM 7
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00731-9759
Mailing Address - Country:US
Mailing Address - Phone:787-259-7952
Mailing Address - Fax:787-812-3153
Practice Address - Street 1:HC9 BOX 17062 BO RIO CHIQUITO KM 2 HM 7
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731-9759
Practice Address - Country:US
Practice Address - Phone:787-259-7952
Practice Address - Fax:787-812-3153
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14249208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21159OtherTRIPLE SSS
PR21159OtherTRIPLE SSS