Provider Demographics
NPI:1689565848
Name:RUIZ SANTANA, TAHIMARYS
Entity type:Individual
Prefix:
First Name:TAHIMARYS
Middle Name:
Last Name:RUIZ SANTANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8209 MALVERN CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-2242
Mailing Address - Country:US
Mailing Address - Phone:754-267-1354
Mailing Address - Fax:
Practice Address - Street 1:8209 MALVERN CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-2242
Practice Address - Country:US
Practice Address - Phone:754-267-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-447566106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician