Provider Demographics
NPI:1851684732
Name:RUIZ, EMELYN ELENA (BCABA)
Entity type:Individual
Prefix:
First Name:EMELYN
Middle Name:ELENA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:EMELYN
Other - Middle Name:ELENA
Other - Last Name:CORTEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:430 NW 23RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4422
Mailing Address - Country:US
Mailing Address - Phone:305-333-0847
Mailing Address - Fax:
Practice Address - Street 1:10920 SW 184TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6608
Practice Address - Country:US
Practice Address - Phone:305-378-5775
Practice Address - Fax:305-378-5772
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-14-6255106E00000X
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst