Provider Demographics
NPI:1780352104
Name:RUIZ AVILES, CLAUDIA JR
Entity type:Individual
Prefix:MISS
First Name:CLAUDIA
Middle Name:
Last Name:RUIZ AVILES
Suffix:JR
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 1:5249 NW 7TH ST APT 311
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3377
Mailing Address - Country:US
Mailing Address - Phone:786-354-4590
Mailing Address - Fax:
Practice Address - Street 1:815 NW 57TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2042
Practice Address - Country:US
Practice Address - Phone:786-693-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-122002106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111761100Medicaid