Provider Demographics
NPI:1932988870
Name:TRISTA RUIZ, ANA LOREN
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:LOREN
Last Name:TRISTA RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15264 SW 178TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-7727
Mailing Address - Country:US
Mailing Address - Phone:305-967-4157
Mailing Address - Fax:
Practice Address - Street 1:15264 SW 178TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-7727
Practice Address - Country:US
Practice Address - Phone:305-967-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist