MEDICARE: RONIE J ZARUCHES OD LLC

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	261QH0100X	Health Service Clinic/Center	OPC2462	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	:	1215251467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONIE J ZARUCHES OD LLC

Provider Business Mailing Address
First Line	:	6380 NW 110TH AVE
Second Line	:
City	:	PARKLAND
State	:	FL
Zip	:	33076-3735
Country	:	US
Telephone Number	:	561-789-3868
Fax Number	:

Provider Business Practice Location Address
First Line	:	143 N POWERLINE RD
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-8037
Country	:	US
Telephone Number	:	561-789-3868
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RONIE ZARUCHES
Credential	:
Telephone Number	:	561-789-3868

Provider Enumeration Date	:	03/17/2010
Last Update Date	:	03/17/2010

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