MEDICARE: HELIODORO RUIZ MD

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	246ZC0007X	Surgical Assistant	09-236
2	208D00000X	General Practice Physician	ACN1275	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831529932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELIODORO RUIZ MD

Provider Business Mailing Address
First Line	:	8752 SW 2ND TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-3937
Country	:	US
Telephone Number	:	786-419-6202
Fax Number	:

Provider Business Practice Location Address
First Line	:	4218 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-2306
Country	:	US
Telephone Number	:	305-266-2929
Fax Number	:	786-558-0242

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2013
Last Update Date	:	11/30/2020

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