Provider Demographics
NPI:1639856503
Name:RUIZ, PAOLA ANDREA (APRN)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:ANDREA
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 1:17226 NW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-3187
Mailing Address - Country:US
Mailing Address - Phone:305-484-3013
Mailing Address - Fax:
Practice Address - Street 1:4302 ALTON ROAD
Practice Address - Street 2:MSOP BUILDING, SUITE 720
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3187
Practice Address - Country:US
Practice Address - Phone:305-532-4835
Practice Address - Fax:305-532-0662
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026679363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily