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Organization

HEARTLAND OTOLARYNGOLOGY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSE L. RUIZ M.D. (OWNER/MANAGER)
(407) 518-1810
Entity
Organization

Contact information

Practice address
1172 CYPRESS GLEN CIR, KISSIMMEE, FL 34741-7560
(407) 518-1810
(407) 201-8834
Mailing address
1172 CYPRESS GLEN CIR, KISSIMMEE, FL 34741-7560
(407) 518-1810
(407) 201-8834

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME0058319
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
064221500
FL
Enumeration date
09/01/2006
Last updated
01/03/2014
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