Provider Demographics
NPI:1588272371
Name:RUIZ, TANYA MARIE (BSN RN)
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:MARIE
Last Name:RUIZ
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2124 J LAWSON BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-4342
Mailing Address - Country:US
Mailing Address - Phone:917-596-1993
Mailing Address - Fax:
Practice Address - Street 1:229 W 36TH ST FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-7529
Practice Address - Country:US
Practice Address - Phone:212-695-5122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY655183163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty