MEDICARE: MICHELLE MARIE RUFFALO L.M., CPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	MW244	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114228038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MARIE RUFFALO L.M., CPM

Provider Business Mailing Address
First Line	:	8326 PINE RIVER RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33637-1011
Country	:	US
Telephone Number	:	321-223-6707
Fax Number	:	813-776-3608

Provider Business Practice Location Address
First Line	:	1845 COLLIER PKWY STE C
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33549-8718
Country	:	US
Telephone Number	:	813-461-3844
Fax Number	:	813-776-3608

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2010
Last Update Date	:	02/16/2024

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