Provider Demographics
NPI:1942360573
Name:RUIZ, HUGO (DDS)
Entity Type:Individual
Prefix:
First Name:HUGO
Middle Name:
Last Name:RUIZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4812 N HABANA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-6871
Mailing Address - Country:US
Mailing Address - Phone:813-873-0271
Mailing Address - Fax:813-873-2929
Practice Address - Street 1:4812 N HABANA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-6871
Practice Address - Country:US
Practice Address - Phone:813-873-0271
Practice Address - Fax:813-873-2929
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN126391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice