Provider Demographics
NPI:1144072646
Name:TETRIS HEALTH CORP
Entity type:Organization
Organization Name:TETRIS HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSMANY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-389-7304
Mailing Address - Street 1:900 W 49TH ST STE 424
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3487
Mailing Address - Country:US
Mailing Address - Phone:786-460-4040
Mailing Address - Fax:786-460-5050
Practice Address - Street 1:900 W 49TH ST STE 424
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3487
Practice Address - Country:US
Practice Address - Phone:786-460-4040
Practice Address - Fax:786-460-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty