Healthcare Provider Details

I. General information

NPI: 1639613995
Provider Name (Legal Business Name): GABRIJELA MEKIC-RUIZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2016
Last Update Date: 09/16/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5010 HOLLYWOO BOULEVARD STE 100B
HOLLYWOOD FL
33021-5801
US

IV. Provider business mailing address

320 NE 12TH AVE APT 101
HALLANDALE BEACH FL
33009-4505
US

V. Phone/Fax

Practice location:
  • Phone: 954-967-0028
  • Fax: 954-967-8141
Mailing address:
  • Phone: 954-449-5965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9310191
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: