Healthcare Provider Details

I. General information

NPI: 1043142474
Provider Name (Legal Business Name): PAULA CRISTINA RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2898 NW 79TH AVE
DORAL FL
33122-1033
US

IV. Provider business mailing address

9367 W 33RD WAY
HIALEAH FL
33018-2053
US

V. Phone/Fax

Practice location:
  • Phone: 305-363-2969
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number26-516059
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: