MEDICARE: KARELIA RUIZ MD PA

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	261QP2300X	Primary Care Clinic/Center	ME92976	FL

General Provider Information

NPI Number	:	1558511345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KARELIA RUIZ MD PA

Provider Business Mailing Address
First Line	:	1949 W 68TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-4403
Country	:	US
Telephone Number	:	305-828-9100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1949 W 68TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-4403
Country	:	US
Telephone Number	:	305-828-9100
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KARELIA RUIZ
Credential	:	M.D.
Telephone Number	:	305-828-9100

Provider Enumeration Date	:	09/29/2008
Last Update Date	:	09/29/2008

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