Provider Demographics
NPI:1326160193
Name:RUIZ, OSMANI
Entity Type:Individual
Prefix:
First Name:OSMANI
Middle Name:
Last Name:RUIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 W 49TH ST STE 224
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2946
Mailing Address - Country:US
Mailing Address - Phone:305-817-2343
Mailing Address - Fax:305-817-2344
Practice Address - Street 1:1800 W 49TH ST STE 224
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2946
Practice Address - Country:US
Practice Address - Phone:305-817-2343
Practice Address - Fax:305-817-2344
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6680111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation