Basic Information
| Provider Information | |||||||||
| NPI: | 1962480830 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUIZ RODRIGUEZ | ||||||||
| FirstName: | ORLANDO | ||||||||
| MiddleName: | I | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 919741 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328919741 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2184284913 | ||||||||
| FaxNumber: | 2184363043 | ||||||||
| Practice Location | |||||||||
| Address1: | 1222 S ORANGE AVE | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328061215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3218417856 | ||||||||
| FaxNumber: | 3218436432 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2006 | ||||||||
| LastUpdateDate: | 06/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 111442 | MO | N | Other Service Providers | Specialist | 207RC0200X | 036-106976 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RC0200X | ME97401 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | ME0097401 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 1962480830 | 01 | IL | MULTIPLAN/PHCS | OTHER | 1962480830 | 01 | IL | HUMANA/CHOICE CARE | OTHER | 1962480830 | 01 | IL | UHC | OTHER | 7178107 | 01 | IL | AETNA | OTHER | 1962480830 | 01 | IL | TRICARE STANDARD | OTHER | 277819000 | 05 | FL | MEDICAID | 036106976 | 05 | IL | MEDICAID | 1962480830 | 01 | IL | MERCY HEALTH PLANS | OTHER | 1962480830 | 05 | MO | MEDICAID | 3876271 | 01 | IL | CIGNA | OTHER | 463598 | 01 | IL | HEALTHLINK | OTHER | 753031110 | 01 | IL | TRICARE PRIME | OTHER | 809681 | 01 | IL | COVENTRY NATIONAL | OTHER | P00720332 | 01 | IL | RAILROAD MEDICARE | OTHER | 6032378 | 01 | IL | BLUECROSS BLUESHIELD | OTHER | ME97401 | 01 | FL | MEDICAL LICENSE | OTHER | 483954 | 01 | IL | GHP | OTHER | 000000470469 | 01 | MO | BLUECROSS BLUESHIELD | OTHER | 1962480830 | 01 | IL | BEECHSTREET/PPONEXT | OTHER | 753031110 | 01 | IL | HFN | OTHER | 76359 | 01 | IL | HEALTH ALLIANCE | OTHER |