Provider Demographics
NPI:1669263877
Name:CASADO RUIZ, NIVIAN JOAN (RN)
Entity type:Individual
Prefix:
First Name:NIVIAN
Middle Name:JOAN
Last Name:CASADO RUIZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-2606
Mailing Address - Country:US
Mailing Address - Phone:850-241-8150
Mailing Address - Fax:
Practice Address - Street 1:4950 JACKSON ST
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-2606
Practice Address - Country:US
Practice Address - Phone:850-241-8150
Practice Address - Fax:850-851-2183
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9447197163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse