Provider Demographics
NPI:1912798505
Name:RUIZ, JOHANNA IVETTE (FNP-BC)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:IVETTE
Last Name:RUIZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 BRICKELL KEY BLVD APT 2302
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2682
Mailing Address - Country:US
Mailing Address - Phone:305-987-5964
Mailing Address - Fax:
Practice Address - Street 1:701 BRICKELL KEY BLVD APT 2302
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2682
Practice Address - Country:US
Practice Address - Phone:305-987-5964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11039090207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine