Healthcare Provider Details

I. General information

NPI: 1902149511
Provider Name (Legal Business Name): BRIANNA RUIZ VARAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2013
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 NW 110TH AVE STE 104
MIAMI FL
33172-1928
US

IV. Provider business mailing address

1695 NW 110TH AVE STE 104
MIAMI FL
33172-1928
US

V. Phone/Fax

Practice location:
  • Phone: 786-631-3222
  • Fax:
Mailing address:
  • Phone: 786-631-3222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME127371
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: