Provider Demographics
NPI:1184381204
Name:CARRANZA, RUBEN JOSE (APRN)
Entity type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:JOSE
Last Name:CARRANZA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12484 SW 119TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5178
Mailing Address - Country:US
Mailing Address - Phone:305-924-4820
Mailing Address - Fax:
Practice Address - Street 1:3342 BROADWAY
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-2328
Practice Address - Country:US
Practice Address - Phone:561-249-4409
Practice Address - Fax:561-909-2071
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11015358363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health