Provider Demographics
NPI:1215912829
Name:RUIZ, JOSE ISRAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ISRAEL
Last Name:RUIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3287 GROUSE AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-9281
Mailing Address - Country:US
Mailing Address - Phone:787-525-6111
Mailing Address - Fax:
Practice Address - Street 1:3287 GROUSE AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-9281
Practice Address - Country:US
Practice Address - Phone:787-525-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12402207P00000X, 207R00000X
FLME78717207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine