MEDICARE: YARISEL RUIZ PORRO

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	11044313	FL

General Provider Information

NPI Number	:	1487519765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YARISEL RUIZ PORRO

Provider Business Mailing Address
First Line	:	15877 SW 44TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-5308
Country	:	US
Telephone Number	:	786-334-1839
Fax Number	:

Provider Business Practice Location Address
First Line	:	15877 SW 44TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-5308
Country	:	US
Telephone Number	:	786-334-1839
Fax Number	:

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

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/19/2025

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Directions to “ YARISEL RUIZ PORRO ” Practice Location

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