Healthcare Provider Details

I. General information

NPI: 1669142766
Provider Name (Legal Business Name): ELIZABETH RUIZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N KENDALL DR STE 706E
MIAMI FL
33176-2150
US

IV. Provider business mailing address

10362 SW 11TH ST
MIAMI FL
33174-2707
US

V. Phone/Fax

Practice location:
  • Phone: 786-534-8884
  • Fax:
Mailing address:
  • Phone: 305-205-6326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: