Individual
MRS. IZZET RUIZ OJEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10703 GLEN IVY LN, TAMPA, FL 33624-5203
(813) 325-0759
Mailing address
10703 GLEN IVY LN, TAMPA, FL 33624-5203
(813) 325-0759
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1235
PR
Other
Enumeration date
04/12/2022
Last updated
04/25/2022
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