Healthcare Provider Details

I. General information

NPI: 1033454376
Provider Name (Legal Business Name): FELIPE RUIZ CONTRO D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2012
Last Update Date: 11/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7990 SW 117TH AVE STE 205
MIAMI FL
33183-4865
US

IV. Provider business mailing address

7990 SW 117TH AVE STE 205
MIAMI FL
33183-4865
US

V. Phone/Fax

Practice location:
  • Phone: 305-271-7447
  • Fax: 305-271-7448
Mailing address:
  • Phone: 305-271-7447
  • Fax: 305-271-7448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 10792
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: