Healthcare Provider Details

I. General information

NPI: 1932045556
Provider Name (Legal Business Name): ANISLEY RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8103 CAMINO REAL APT 212C
MIAMI FL
33143-6734
US

IV. Provider business mailing address

8103 CAMINO REAL APT 212C APT 212C
MIAMI FL
33143-6734
US

V. Phone/Fax

Practice location:
  • Phone: 786-391-8311
  • Fax:
Mailing address:
  • Phone: 786-391-8311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License NumberTN59584
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: