Individual
RUDDY E RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 DAIRY RD, MELBOURNE, FL 32904-4046
(321) 952-0494
(321) 952-0479
Mailing address
1900 DAIRY RD, MELBOURNE, FL 32904-4046
(321) 952-0494
(321) 952-0479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME68400
FL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
ME68400
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110112878
RR MEDICARE
FL
05
—
379019300
—
FL
Enumeration date
12/02/2005
Last updated
04/04/2013
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