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General NPI Number Information
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NPI Number | 1659907848
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Entity Type | Individual
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Provider Name | DANNY RUIZ
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Gender | Male
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Dates
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Enumeration Date | 03/19/2020
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | 3990 W FLAGLER ST STE 205
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City | CORAL GABLES
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State | FL
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Zip | 33134-1644
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Country | US
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Telephone | 786-618-5151
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Fax | 786-618-5143
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Provider Business Mailing Address
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Address Line | 3990 W FLAGLER ST STE 205
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City | CORAL GABLES
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State | FL
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Zip | 33134-1644
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Country | US
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Telephone | 786-618-5151
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Fax | 786-618-5143
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MM40432
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License Number State | FL
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