Provider Demographics
NPI:1679066435
Name:DIAZ RUIZ, DANNEL (MD)
Entity type:Individual
Prefix:
First Name:DANNEL
Middle Name:
Last Name:DIAZ RUIZ
Suffix:
Gender:
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 425
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-0425
Mailing Address - Country:US
Mailing Address - Phone:787-477-8410
Mailing Address - Fax:
Practice Address - Street 1:313 CALLE PIRINEO
Practice Address - Street 2:MIRADERO HILLS
Practice Address - City:MAYAGUEZ,
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-477-8410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR35253-R207R00000X
PR14699-I390200000X
PR23235207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program