Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 6812 | NV |
Y | 1223P0221X | Pediatric Dentist | DN25342 | FL |
N | 1223P0221X | Pediatric Dentist | S6-148 | NV |
NPI | 1023561826 |
---|---|
Provider Name | Doribeth Ruiz |
First Address | Cape Coral, FL 33990-3617 |
Second Address | Cape Coral, FL 33990-3617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2016 |
Last Update Date | 28/09/2021 |