Provider Demographics
NPI:1821290438
Name:RUIZ, JOAQUIN R (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOAQUIN
Middle Name:R
Last Name:RUIZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 E 52ND ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1552
Mailing Address - Country:US
Mailing Address - Phone:305-687-0744
Mailing Address - Fax:305-687-0744
Practice Address - Street 1:1243 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4003
Practice Address - Country:US
Practice Address - Phone:305-854-8544
Practice Address - Fax:305-854-6463
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0014906183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist