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General NPI Number Information
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NPI Number | 1487478632
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Entity Type | Individual
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Provider Name | TYANA UNICE RUIZ PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 13515 LAKE TERRACE LN STE A1016
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City | TAMPA
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State | FL
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Zip | 33637-1003
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Country | US
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Telephone | 813-815-7150
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Fax |
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Provider Business Mailing Address
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Address Line | 111 E FLAGLER ST APT 1509
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City | MIAMI
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State | FL
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Zip | 33131-1110
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Country | US
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Telephone | 174-270-7781
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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