Healthcare Provider Details

I. General information

NPI: 1811330897
Provider Name (Legal Business Name): MARIA PAULA RUIZ D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 W NEWBERRY RD STE 103
GAINESVILLE FL
32605-4384
US

IV. Provider business mailing address

6400 W NEWBERRY RD STE 103
GAINESVILLE FL
32605-4384
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-5946
  • Fax: 352-333-5947
Mailing address:
  • Phone: 352-333-5946
  • Fax: 352-333-5947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberOS16460
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number81739-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: