Mark David Ruiz, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY10437 Issued in FL

Practice address

79 Bay Bridge Dr
Gulf Breeze, FL 32561-4468

Phone

(850) 741-5438

Fax

(850) 726-4784

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Live Oak Minds LLC

  • Clinical Psychologist
  • Gulf Breeze, FL
  • NPI 1902467624
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1669418554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 BAY BRIDGE DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614468",
            "telephone_number": "850-741-5438",
            "fax_number": "850-726-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 BAY BRIDGE DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614468",
            "telephone_number": "850-741-5438",
            "fax_number": "850-726-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Ropp
• Damien Ekki Rosa, DPT
• Kendall Alina Rosebrock, LAT, ATC
• Travis Roth, M.D.
• Lee Ann Ruffin, BSPT
• Sakara Nicole Runge
• Karen Elaine Rushing-Holtgrewe, RNFA
• Sacred Heart Health System, Inc.
• Sacred Heart Health System, Inc.
• Sacred Heart Medical Group

• Clinical Psychologist in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.