Healthcare Provider Details

I. General information

NPI: 1639319114
Provider Name (Legal Business Name): HAZEL LEE RUFF-JAMES FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 SNIVELY AVE
ELOISE FL
33880-5531
US

IV. Provider business mailing address

996 BUCCANEER BLVD
WINTER HAVEN FL
33880-1965
US

V. Phone/Fax

Practice location:
  • Phone: 863-287-5559
  • Fax: 863-875-6908
Mailing address:
  • Phone: 863-875-5595
  • Fax: 863-875-6908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024166077
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11030869
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0017138086
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: