Provider Demographics
NPI:1902972037
Name:RUIZ-GO, ROSALINE J (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROSALINE
Middle Name:J
Last Name:RUIZ-GO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:RUIZ-GO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:335 LEGARE CT
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2900
Mailing Address - Country:US
Mailing Address - Phone:561-676-0684
Mailing Address - Fax:561-630-9383
Practice Address - Street 1:850 W INDIANTOWN RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7539
Practice Address - Country:US
Practice Address - Phone:561-746-4112
Practice Address - Fax:561-575-6738
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6330225100000X
FL63302251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics