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General NPI Number Information
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NPI Number | 1174077440
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Entity Type | Individual
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Provider Name | MABEL RUIZ APRN
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Gender | Female
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 258 S CHICKASAW TRL STE 210
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City | ORLANDO
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State | FL
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Zip | 32825-3501
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Country | US
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Telephone | 407-645-1847
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Fax | 321-274-0322
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Provider Business Mailing Address
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Address Line | 258 S CHICKASAW TRL STE 210
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City | ORLANDO
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State | FL
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Zip | 32825-3501
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Country | US
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Telephone | 407-303-6588
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Fax | 407-303-6592
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP 9176071
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License Number State | FL
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