MEDICARE: CARLOS HERIBERTO RUIZ MD

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	ME80316	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	260049118	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	QP199	OTHER	FL	HFMG MA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	03717	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1508804766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS HERIBERTO RUIZ MD

Provider Business Mailing Address
First Line	:	425 W COLONIAL DR STE 302
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6863
Country	:	US
Telephone Number	:	407-601-1370
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 W COLONIAL DR STE 302
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6863
Country	:	US
Telephone Number	:	407-601-1370
Fax Number	:

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	04/14/2023

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Directions to “ CARLOS HERIBERTO RUIZ MD” Practice Location

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