Provider Demographics
NPI:1467220269
Name:RUIZ, JORGE JR (ARNP)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:RUIZ
Suffix:JR
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19045 E SAINT ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2314
Mailing Address - Country:US
Mailing Address - Phone:786-487-7051
Mailing Address - Fax:
Practice Address - Street 1:7000 NW 41ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-6817
Practice Address - Country:US
Practice Address - Phone:786-263-5341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF05220277363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily