Provider Demographics
NPI:1477305472
Name:RUIZ, MAYELIN (APRN,FNP-C)
Entity Type:Individual
Prefix:
First Name:MAYELIN
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:APRN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22634 SW 109TH PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-3051
Mailing Address - Country:US
Mailing Address - Phone:786-975-9865
Mailing Address - Fax:
Practice Address - Street 1:22634 SW 109TH PATH
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-3051
Practice Address - Country:US
Practice Address - Phone:786-975-9865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11032145363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily