Healthcare Provider Details

I. General information

NPI: 1649519133
Provider Name (Legal Business Name): RUXANDRA I CIUCA M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9399 BOCA GARDENS CIR S #D
BOCA RATON FL
33496-1702
US

IV. Provider business mailing address

9399 BOCA GARDENS CIR S #D
BOCA RATON FL
33496-1702
US

V. Phone/Fax

Practice location:
  • Phone: 954-304-3108
  • Fax:
Mailing address:
  • Phone: 954-304-3108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ5952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: