Provider Demographics
NPI:1356540975
Name:RUIZ FERNANDEZ, JUDHIT C (MD)
Entity type:Individual
Prefix:
First Name:JUDHIT
Middle Name:C
Last Name:RUIZ FERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7551 WILES RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2064
Mailing Address - Country:US
Mailing Address - Phone:954-341-4245
Mailing Address - Fax:954-752-7117
Practice Address - Street 1:7551 WILES RD
Practice Address - Street 2:SUITE 104
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2064
Practice Address - Country:US
Practice Address - Phone:954-341-4245
Practice Address - Fax:954-752-7117
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100868207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000865300Medicaid