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General NPI Number Information
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NPI Number | 1447783246
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Entity Type | Individual
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Provider Name | MAYTE SOLANGE RUIZ SANTIAGO M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 900 W 49TH ST STE 502
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City | HIALEAH
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State | FL
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Zip | 33012-3488
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Country | US
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Telephone | 786-618-5182
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Fax | 567-345-6138
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Provider Business Mailing Address
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Address Line | 5750 COLLINS AVE APT 14G
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2313
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Country | US
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Telephone | 305-200-7681
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Fax | 786-558-5984
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 144232
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License Number State | FL
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