Provider Demographics
NPI:1780870311
Name:RUIZ, CATALINA (OD)
Entity type:Individual
Prefix:DR
First Name:CATALINA
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 S CLUB DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-1077
Mailing Address - Country:US
Mailing Address - Phone:786-259-2178
Mailing Address - Fax:
Practice Address - Street 1:13860 WELLINGTON TRCE STE 3
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-8589
Practice Address - Country:US
Practice Address - Phone:561-798-8838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4279152W00000X
FLOPC 4279152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAI681(U).Medicare PIN
FLAI681YMedicare PIN