Provider Demographics
NPI:1548379126
Name:RUIZ, DORIS NILDA (PT)
Entity Type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:NILDA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24301SW 192AVENUE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33031
Mailing Address - Country:US
Mailing Address - Phone:305-246-4633
Mailing Address - Fax:
Practice Address - Street 1:24301SW 192AVENUE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33031
Practice Address - Country:US
Practice Address - Phone:305-246-4633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT3066225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist