Provider Demographics
NPI:1174766166
Name:ALTIERY RUIZ, CARMEN I (MD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:I
Last Name:ALTIERY RUIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6830 CARR 4484
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-2750
Mailing Address - Country:US
Mailing Address - Phone:787-609-6468
Mailing Address - Fax:787-609-3017
Practice Address - Street 1:CARR. 4494 KM 1.2 INT CALLE LA CUMBRE # 360
Practice Address - Street 2:BO ARENALES
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-609-6468
Practice Address - Fax:787-609-3017
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR17500208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice