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NPI Code Detail

MEDICARE: MADELINE RUIZ-SOTO BA

MEDICARE:   MADELINE  RUIZ-SOTO  BA
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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1932373495
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE RUIZ-SOTO BA
Provider Business Mailing Address
First Line : 4014 W WATERS AVE APT 1807
Second Line :
City : TAMPA
State : FL
Zip : 33614-8115
Country : US
Telephone Number : 813-846-4965
Fax Number :
Provider Business Practice Location Address
First Line : 7528 CLEARVIEW DR
Second Line :
City : TAMPA
State : FL
Zip : 33634-2930
Country : US
Telephone Number : 813-846-4965
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2008
Last Update Date : 03/30/2010

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Directions to “ MADELINE RUIZ-SOTO BA” Practice Location

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