Healthcare Provider Details

I. General information

NPI: 1235144932
Provider Name (Legal Business Name): RHENA MARIALIZA RUIZ-NOVERO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RHENA MARIALIZA RUIZ M.D.

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 CYPRESS WAY E STE 10
NAPLES FL
34110-9275
US

IV. Provider business mailing address

2675 WINKLER AVE FL 2
FORT MYERS FL
33901-9342
US

V. Phone/Fax

Practice location:
  • Phone: 239-302-3295
  • Fax: 239-302-3296
Mailing address:
  • Phone: 877-856-3774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number48432-020
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME101279
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: