Provider Demographics
NPI:1770356164
Name:RUIZ RAMIREZ, NUVIA
Entity type:Individual
Prefix:
First Name:NUVIA
Middle Name:
Last Name:RUIZ RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11350 SW 28TH ST APT 413
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7733
Mailing Address - Country:US
Mailing Address - Phone:786-370-9429
Mailing Address - Fax:
Practice Address - Street 1:11350 SW 28TH ST APT 413
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7733
Practice Address - Country:US
Practice Address - Phone:786-370-9429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-301576106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty