Provider Demographics
NPI:1275314627
Name:RUIZ REINA, VALERIA ALEJANDRA
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:ALEJANDRA
Last Name:RUIZ REINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2244 WHITE PINE CIR APT A
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33415-6045
Mailing Address - Country:US
Mailing Address - Phone:561-971-4066
Mailing Address - Fax:
Practice Address - Street 1:2244 WHITE PINE CIR APT A
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33415-6045
Practice Address - Country:US
Practice Address - Phone:561-971-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA97686225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist