Healthcare Provider Details

I. General information

NPI: 1023272234
Provider Name (Legal Business Name): RUYI-1 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2635 NW 205TH ST
MIAMI GARDENS FL
33056-1566
US

IV. Provider business mailing address

2635 NW 205TH ST
MIAMI GARDENS FL
33056-1566
US

V. Phone/Fax

Practice location:
  • Phone: 305-978-7894
  • Fax:
Mailing address:
  • Phone: 305-978-7894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. VICTOR OMORUYI
Title or Position: PRESIDENT
Credential:
Phone: 305-978-7894