Individual
MRS. SAMADHY RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5750 W. THUNDERBIRD AVE, SUITE B- 200, GLENDALE, AZ 85306-4660
(602) 375-1700
(602) 843-2847
Mailing address
128 INTERIOR CALLE BUENA VISTA, MAYAGUEZ, PR 00680
(787) 209-5455
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3183
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z2614
HEALTHNET
AZ
05
—
959497
—
AZ
01
—
F05992
PACIFICARE
AZ
Enumeration date
12/15/2005
Last updated
09/22/2020
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