Healthcare Provider Details

I. General information

NPI: 1437175510
Provider Name (Legal Business Name): RUDY A VILBRUN RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 03/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8291 EMERALD WINDS CIR
BOYNTON BEACH FL
33473-7839
US

IV. Provider business mailing address

8291 EMERALD WINDS CIR
BOYNTON BEACH FL
33473-7839
US

V. Phone/Fax

Practice location:
  • Phone: 561-628-9924
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License NumberRT 8371
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: