Healthcare Provider Details

I. General information

NPI: 1821785783
Provider Name (Legal Business Name): ULTRAHEALTH, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5038 CORONADO PKWY
NAPLES FL
34116-6950
US

IV. Provider business mailing address

5038 CORONADO PKWY
NAPLES FL
34116-6950
US

V. Phone/Fax

Practice location:
  • Phone: 239-499-0900
  • Fax: 239-692-9321
Mailing address:
  • Phone: 305-418-0580
  • Fax: 305-402-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIELA RUIZ
Title or Position: OWNER
Credential:
Phone: 754-208-9566