Provider Demographics
NPI:1942896337
Name:RUIZ, YUDENIA (PHARMD)
Entity type:Individual
Prefix:
First Name:YUDENIA
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 SW 164TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5103
Mailing Address - Country:US
Mailing Address - Phone:561-723-9349
Mailing Address - Fax:
Practice Address - Street 1:7199 SW 117TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-2807
Practice Address - Country:US
Practice Address - Phone:305-273-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist