MEDICARE: RUYI-1 INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		FL

General Provider Information

NPI Number	:	1023272234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUYI-1 INC

Provider Business Mailing Address
First Line	:	2635 NW 205TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-1566
Country	:	US
Telephone Number	:	305-978-7894
Fax Number	:

Provider Business Practice Location Address
First Line	:	2635 NW 205TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-1566
Country	:	US
Telephone Number	:	305-978-7894
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VICTOR OMORUYI
Credential	:
Telephone Number	:	305-978-7894

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	07/18/2008

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