Individual
MARIO AUGUSTO CORONA RUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2225 PONCE BYP STE 502, PONCE, PR 00717-1368
(787) 934-7737
Mailing address
105 AVE ARTERIAL HOSTOS, APT V201 OR APARTADO 216, SAN JUAN, PR 00918
(939) 645-6398
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
22921
PR
207Y00000X
Otolaryngology Physician
69904
MN
207YX0901X
Otology & Neurotology Physician
22921
PR
390200000X
Student in an Organized Health Care Education/Training Program
4927717
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4937717
DRIVER LICENSE
PR
Enumeration date
09/16/2014
Last updated
10/20/2022
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