Provider Demographics
NPI:1386437929
Name:RUIZ, SAMANTHA (SLPA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8929 NW 111TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4570
Mailing Address - Country:US
Mailing Address - Phone:786-879-3881
Mailing Address - Fax:
Practice Address - Street 1:8200 NW 27TH ST
Practice Address - Street 2:STE 101
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1902
Practice Address - Country:US
Practice Address - Phone:305-390-1027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI79482355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant