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General NPI Number Information
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NPI Number | 1558083337
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Entity Type | Individual
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Provider Name | ALEXIS RUIZ LINARES CBHCM
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Gender | Male
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 640 W PALM DR STE D
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City | FLORIDA CITY
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State | FL
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Zip | 33034-3237
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Country | US
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Telephone | 786-601-7757
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Fax | 786-601-7758
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Provider Business Mailing Address
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Address Line | 10907 SW 88TH ST APT 423
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City | MIAMI
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State | FL
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Zip | 33176-1276
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Country | US
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Telephone | 512-770-5606
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | CBHCM.0104285
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License Number State | FL
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