Healthcare Provider Details

I. General information

NPI: 1326160193
Provider Name (Legal Business Name): OSMANI RUIZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W 49TH ST STE 224
HIALEAH FL
33012-2946
US

IV. Provider business mailing address

1800 W 49TH ST STE 224
HIALEAH FL
33012-2946
US

V. Phone/Fax

Practice location:
  • Phone: 305-817-2343
  • Fax: 305-817-2344
Mailing address:
  • Phone: 305-817-2343
  • Fax: 305-817-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH 6680
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: