Individual
FREDY RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3211 PONCE DE LEON BLVD, SUITE 102, CORAL GABLES, FL 33134-7274
(305) 443-3480
Mailing address
3025 NW 99TH PL, DORAL, FL 33172-1046
(786) 261-8763
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9109956
FL
363AS0400X
Surgical Physician Assistant
PA9109956
FL
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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