Provider Demographics
NPI:1982127882
Name:RUIZ, PATRICIA (OD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
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 1:8079 W 36TH AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1806
Mailing Address - Country:US
Mailing Address - Phone:786-379-6195
Mailing Address - Fax:
Practice Address - Street 1:1925 BRICKELL AVE STE D202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-2900
Practice Address - Country:US
Practice Address - Phone:305-914-0294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-23
Last Update Date:2017-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5453152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist