Provider Demographics
NPI:1639737760
Name:GARCIA RUIZ, AMANDA (MS)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:GARCIA RUIZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14127 SANCTUARY TERRACE LN UNIT 301
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6643
Mailing Address - Country:US
Mailing Address - Phone:386-414-0432
Mailing Address - Fax:
Practice Address - Street 1:14127 SANCTUARY TERRACE LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6643
Practice Address - Country:US
Practice Address - Phone:407-860-8950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities