Provider Demographics
NPI:1962971937
Name:RUIZ COIMBRE, JORGE G (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:G
Last Name:RUIZ COIMBRE
Suffix:
Gender:M
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:PO BOX 7251
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7251
Mailing Address - Country:US
Mailing Address - Phone:787-362-7444
Mailing Address - Fax:787-829-0251
Practice Address - Street 1:10 CALLE RIUS RIVERA
Practice Address - Street 2:
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601-2335
Practice Address - Country:US
Practice Address - Phone:787-829-1096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21163208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice