Healthcare Provider Details

I. General information

NPI: 1184547358
Provider Name (Legal Business Name): NAOMI RUIZ COFFAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 RIDGE POINTE DR APT D
BOYNTON BEACH FL
33435-6504
US

IV. Provider business mailing address

13960 LAKE PLACID CT
MIAMI LAKES FL
33014-3087
US

V. Phone/Fax

Practice location:
  • Phone: 954-751-5722
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: