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Individual

ALEX GONZALEZ RUIZ I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
760 NW 107TH AVE, MIAMI, FL 33172-3162
(786) 334-6928
(786) 828-7919
Mailing address
320 NW 199TH ST, MIAMI, FL 33169-2923
(305) 397-7529

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16010
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
790900379
FL
Enumeration date
11/23/2021
Last updated
11/23/2021
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