Basic Information
| Provider Information | |||||||||
| NPI: | 1316302789 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PINO RUIZ | ||||||||
| FirstName: | DANIEL | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14570 NW 77TH CT | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MIAMI LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330161507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056855688 | ||||||||
| FaxNumber: | 7866185307 | ||||||||
| Practice Location | |||||||||
| Address1: | 777 E 25TH ST | ||||||||
| Address2: | SUITE 118 | ||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330133825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056855688 | ||||||||
| FaxNumber: | 7866185307 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2015 | ||||||||
| LastUpdateDate: | 12/29/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | ARNP9385406 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.