Provider Demographics
NPI:1396551081
Name:RUIZ ORASMA, ALFREDO PASQUALE (HOUSE PHYSYCIAN, MD)
Entity type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:PASQUALE
Last Name:RUIZ ORASMA
Suffix:
Gender:M
Credentials:HOUSE PHYSYCIAN, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 PALM TRACE LANDINGS DR APT 109
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-1861
Mailing Address - Country:US
Mailing Address - Phone:786-436-6406
Mailing Address - Fax:
Practice Address - Street 1:2845 AVENTURA BLVD STE 240
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3120
Practice Address - Country:US
Practice Address - Phone:305-692-1074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL41416208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice