MEDICARE: FATIMA XIOMARA RUIZ NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11006415	FL

General Provider Information

NPI Number	:	1124692421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATIMA XIOMARA RUIZ NP

Provider Business Mailing Address
First Line	:	5901 WEBB RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3219
Country	:	US
Telephone Number	:	813-888-8215
Fax Number	:	813-885-5398

Provider Business Practice Location Address
First Line	:	210 SEBRING SQ
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-1622
Country	:	US
Telephone Number	:	863-658-5066
Fax Number	:	863-340-8792

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2021
Last Update Date	:	03/23/2026

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