MEDICARE: DR. RUBY ANNE DEVERAS MD

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	207RH0003X	Hematology & Oncology Physician	ME75526	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	:	1306844360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUBY ANNE DEVERAS MD

Provider Business Mailing Address
First Line	:	303 N CLYDE MORRIS BLVD
Second Line	:	HALIFAX REGIONAL ONCOLOGY CENTER
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-2709
Country	:	US
Telephone Number	:	386-254-4212
Fax Number	:	386-254-4214

Provider Business Practice Location Address
First Line	:	303 N CLYDE MORRIS BLVD
Second Line	:	HALIFAX REGIONAL ONCOLOGY CENTER
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-2709
Country	:	US
Telephone Number	:	386-254-4212
Fax Number	:	386-254-4214

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	08/10/2012

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