MEDICARE: MAYTE SOLANGE RUIZ SANTIAGO M.D.

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	2084P0800X	Psychiatry Physician	144232	FL

General Provider Information

NPI Number	:	1447783246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYTE SOLANGE RUIZ SANTIAGO M.D.

Provider Business Mailing Address
First Line	:	1890 SW 57TH AVE STE 106
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-2164
Country	:	US
Telephone Number	:	786-536-1701
Fax Number	:	305-847-2447

Provider Business Practice Location Address
First Line	:	900 W 49TH ST STE 512
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-3488
Country	:	US
Telephone Number	:	786-536-1701
Fax Number	:	567-345-6138

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

Provider Enumeration Date	:	04/07/2017
Last Update Date	:	05/05/2026

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