Provider Demographics
NPI:1841665072
Name:RUIZ SOTO, EVA NYDIA (CRNA)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:NYDIA
Last Name:RUIZ SOTO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 QUAYE LAKE CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33411-5058
Mailing Address - Country:US
Mailing Address - Phone:787-233-6747
Mailing Address - Fax:
Practice Address - Street 1:950 QUAYE LAKE CIR APT 101
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33411
Practice Address - Country:US
Practice Address - Phone:787-233-6747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR87032367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered