Organization
BLOOMINGDALE PEDIATRIC ASS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONIA M RUIZ MD (PEDIATRICIAN)
(813) 684-1881
Entity
Organization
Contact information
Practice address
4316 BELL SHOALS RD, VALRICO, FL 33594
(813) 684-1881
(813) 685-0471
Mailing address
4316 BELL SHOALS RD, VALRICO, FL 33594
(813) 684-1881
(813) 685-0471
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME45712
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00559
STAYWELL
—
01
—
208721
AMERIGROUP
—
01
—
26208721
AETNA
—
01
—
62614
BCBS
—
Enumeration date
11/17/2006
Last updated
08/22/2020
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