Provider Demographics
NPI:1013334333
Name:ACOSTA RUIZ, ARMANDO (ARNP)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:ACOSTA RUIZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15238 SW 29TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5674
Mailing Address - Country:US
Mailing Address - Phone:786-925-8094
Mailing Address - Fax:
Practice Address - Street 1:139 NE 15TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4508
Practice Address - Country:US
Practice Address - Phone:305-247-1213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9276026363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily