Provider Demographics
NPI:1225447543
Name:FLORES RUIZ, MELISA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MELISA
Middle Name:
Last Name:FLORES RUIZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14016 SANCTUARY VIEW TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6611
Mailing Address - Country:US
Mailing Address - Phone:787-553-0897
Mailing Address - Fax:
Practice Address - Street 1:2521 13TH ST STE F
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4103
Practice Address - Country:US
Practice Address - Phone:407-900-4885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10203103T00000X
PR5449103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist