Individual provider Active NPI

Patricia Del Carmen Ruiz de Nunez, DMD

  • Dentist
  • Indiantown, FL
National Provider Identifier
1942063763
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN29735 Issued in FL
Practice address
15858 SW Warfield Blvd
Indiantown, FL 34956-3513
Phone
(772) 597-3596
Fax
(772) 248-0070
NPI assigned
Feb 5, 2024
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN29735 FL Primary

Addresses

Primary practice location

15858 SW Warfield Blvd
Indiantown, FL 34956-3513

Mailing address

5827 Corporate Way
West Palm Beach, FL 33407-2000
Phone (561) 844-9443

Other practice location 1

1505 Delaware Ave
Fort Pierce, FL 34950-3975
Phone (772) 461-1402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250415000437 FL Practitioner - Dentist 3678098480 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Community Health Centers Inc Current Accepting new patients
Florida Community Health Centers Inc Current Accepting new patients
Florida Community Health Centers Inc CurrentSince Mar 20, 2025 Accepting new patients
Florida Community Health Centers Inc Current Accepting new patients
Florida Community Health Centers Inc CurrentSince Mar 20, 2025 Accepting new patients

Locations

315 S W C Owen Ave
Clewiston, FL 33440
Phone (561) 996-9573

1505 Delaware Ave
Fort Pierce, FL 34950
Phone (772) 461-1140

15858 SW Warfield Blvd
Indiantown, FL 34956
Phone (772) 597-3596

1021 Health Park Dr
Moore Haven, FL 33471
Phone (863) 946-0405

1100 N Parrott Ave
Okeechobee, FL 34972
Phone (863) 763-1951

5827 Corporate Way
West Palm Beach, FL 33407
Phone (561) 844-9443

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1942063763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5827 CORPORATE WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072000",
            "telephone_number": "561-844-9443",
            "fax_number": "561-844-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15858 SW WARFIELD BLVD",
            "city": "INDIANTOWN",
            "state": "FL",
            "postal_code": "349563513",
            "telephone_number": "772-597-3596",
            "fax_number": "772-248-0070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 Delaware Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349503975",
            "country_code": "US",
            "telephone_number": "772-461-1402",
            "fax_number": "772-252-7114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ DE NUNEZ",
        "first_name": "PATRICIA",
        "middle_name": "DEL CARMEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN29735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiantown, FL

Sources for this page

Verify at the official NPI Registry.