Individual
PHILLIP RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1611 NW 12TH AVE, BOX 016960 M851, MIAMI, FL 33136-1005
(305) 585-6303
Mailing address
1611 NW 12TH AVE, BOX 016960 M851, MIAMI, FL 33136-1005
(305) 585-6303
Taxonomy
Speciality
Code
Description
License number
State
207ZI0100X
Immunopathology Physician
ME55558
FL
207ZP0101X
Anatomic Pathology Physician
Primary
ME55558
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0616044-00
—
FL
Enumeration date
07/28/2006
Last updated
03/02/2023
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