Individual
TERRY MARILYN RAVENNA RUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
4719 CASON COVE DR APT 1504, ORLANDO, FL 32811-6356
(321) 947-2904
Mailing address
4719 CASON COVE DR APT 1504, ORLANDO, FL 32811-6356
(321) 947-2904
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
20-464
WI
Other
Enumeration date
12/05/2020
Last updated
12/05/2020
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