Healthcare Provider Details

I. General information

NPI: 1598026171
Provider Name (Legal Business Name): RODRIGO RUANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 14TH ST STE 507
MIAMI FL
33136-2116
US

IV. Provider business mailing address

1150 NW 14TH ST STE 507
MIAMI FL
33136-2116
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-4365
  • Fax: 305-243-4397
Mailing address:
  • Phone: 305-243-4365
  • Fax: 305-243-4397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1001
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number43729
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMFC1848
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: