| Juan J Perez Ruiz M.d. A Professional Medical Corporation | |
|
461 Heymann Blvd Lafayette LA 70503-2616 | |
| (337) 289-8717 | |
| (337) 289-8718 |
| Full Name | Juan J Perez Ruiz M.d. A Professional Medical Corporation |
|---|---|
| Speciality | Clinic/center |
| Location | 461 Heymann Blvd, Lafayette, Louisiana |
| Authorized Official Name and Position | Juan Jose Perez Ruiz (OWNER) |
| Authorized Official Contact | 3372898717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Juan J Perez Ruiz M.d. A Professional Medical Corporation 461 Heymann Blvd Lafayette LA 70503-2616 Ph: (337) 289-8717 | Juan J Perez Ruiz M.d. A Professional Medical Corporation 461 Heymann Blvd Lafayette LA 70503-2616 Ph: (337) 289-8717 |
| NPI Number | 1457501686 |
|---|---|
| Provider Enumeration Date | 09/24/2008 |
| Last Update Date | 05/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457501686 | NPI | - | NPPES |
| 1821106261 | Other | NPI INDIVIDUAL | |
| 1492558 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 022070 (Louisiana) | Primary |
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