Provider Demographics
NPI:1558956359
Name:RUIZ, YISEL (APRN)
Entity Type:Individual
Prefix:
First Name:YISEL
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 EXECUTIVE DR STE 8
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8140
Mailing Address - Country:US
Mailing Address - Phone:877-817-8346
Mailing Address - Fax:855-952-8346
Practice Address - Street 1:1000 EXECUTIVE DR STE 8
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8140
Practice Address - Country:US
Practice Address - Phone:877-817-8346
Practice Address - Fax:855-952-8346
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009299363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily