Provider Demographics
NPI:1689105249
Name:RUIZ ZAYON, SUMIKO
Entity Type:Individual
Prefix:
First Name:SUMIKO
Middle Name:
Last Name:RUIZ ZAYON
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 1:9129 SW 72ND AVE APT H1
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-1633
Mailing Address - Country:US
Mailing Address - Phone:786-907-0396
Mailing Address - Fax:
Practice Address - Street 1:9129 SW 72ND AVE APT H1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-1633
Practice Address - Country:US
Practice Address - Phone:786-907-0396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst