Provider Demographics
NPI:1750130688
Name:RUIZ PORCEGUES, CLAUDIA LORENA
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:LORENA
Last Name:RUIZ PORCEGUES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3463 NW 181ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-3435
Mailing Address - Country:US
Mailing Address - Phone:786-303-7033
Mailing Address - Fax:
Practice Address - Street 1:1560 SAWGRASS CORPORATE PKWY STE 429
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2858
Practice Address - Country:US
Practice Address - Phone:786-303-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-335181106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician