Provider Demographics
NPI:1831529932
Name:RUIZ, HELIODORO (MD)
Entity type:Individual
Prefix:
First Name:HELIODORO
Middle Name:
Last Name:RUIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8752 SW 2ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3937
Mailing Address - Country:US
Mailing Address - Phone:786-419-6202
Mailing Address - Fax:
Practice Address - Street 1:4218 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-2306
Practice Address - Country:US
Practice Address - Phone:305-266-2929
Practice Address - Fax:786-558-0242
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-26
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
09-236246ZC0007X
FLACN1275208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant