Provider Demographics
NPI:1629509450
Name:RUIZ ARTETA, MARIA PAULINA
Entity Type:Individual
Prefix:
First Name:MARIA PAULINA
Middle Name:
Last Name:RUIZ ARTETA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5581 NW 112TH AVE APT 302
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4135
Mailing Address - Country:US
Mailing Address - Phone:786-720-7553
Mailing Address - Fax:
Practice Address - Street 1:5581 NW 112TH AVE APT 302
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4135
Practice Address - Country:US
Practice Address - Phone:786-720-7553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8498235Z00000X
FLSA17797235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist