MEDICARE: MISS ADRIANA SOFIA RUIZ PA-C

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	363AM0700X	Medical Physician Assistant	PA1383	NV
2	363AM0700X	Medical Physician Assistant	11364	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386997039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ADRIANA SOFIA RUIZ PA-C

Provider Business Mailing Address
First Line	:	1800 HOWELL MILL RD NW STE 450
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2508
Country	:	US
Telephone Number	:	404-355-4393
Fax Number	:	404-609-7665

Provider Business Practice Location Address
First Line	:	1800 HOWELL MILL RD NW STE 450
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2508
Country	:	US
Telephone Number	:	404-355-4393
Fax Number	:	404-609-7665

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

Provider Enumeration Date	:	10/18/2012
Last Update Date	:	04/04/2023

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Directions to “ MISS ADRIANA SOFIA RUIZ PA-C” Practice Location

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