Provider Demographics
NPI:1396557286
Name:RUIZ URQUIA, DELVIS HUMBERTO
Entity type:Individual
Prefix:
First Name:DELVIS
Middle Name:HUMBERTO
Last Name:RUIZ URQUIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7449 FACULTY DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-6404
Mailing Address - Country:US
Mailing Address - Phone:689-231-5681
Mailing Address - Fax:
Practice Address - Street 1:555 WINDERLEY PL STE 300
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7133
Practice Address - Country:US
Practice Address - Phone:386-320-5653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-396949106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician