Healthcare Provider Details

I. General information

NPI: 1760639579
Provider Name (Legal Business Name): HELBERT RUIZ GONZALEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HELBERT EDUARDO RUIZ GONZALEZ MD

II. Dates (important events)

Enumeration Date: 08/22/2008
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2302 COLLEGE AVENUE
CONWAY AR
72034
US

IV. Provider business mailing address

8201 W BROWARD BLVD
PLANTATION FL
33324-2701
US

V. Phone/Fax

Practice location:
  • Phone: 501-513-5156
  • Fax:
Mailing address:
  • Phone: 866-884-2904
  • Fax: 800-792-9021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME112800
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number093080
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE-6219
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: