Provider Demographics
NPI:1861430134
Name:RUIZ, FRANCISCO ROBERTO (MD)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:ROBERTO
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 1:240 N WICKHAM RD STE 309
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-8661
Mailing Address - Country:US
Mailing Address - Phone:321-752-1630
Mailing Address - Fax:321-690-6578
Practice Address - Street 1:240 N WICKHAM RD STE 309
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-8661
Practice Address - Country:US
Practice Address - Phone:321-752-1630
Practice Address - Fax:321-690-6578
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95828207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275569600Medicaid
FL114023300Medicaid
FLBL659YOtherMEDICARE PTAN