Healthcare Provider Details

I. General information

NPI: 1376245746
Provider Name (Legal Business Name): ALEXANDRA RUGGIERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date: 09/04/2026
Reactivation Date: 09/10/2026

III. Provider practice location address

3600 N OCEAN BLVD
FORT LAUDERDALE FL
33308-6424
US

IV. Provider business mailing address

3600 N OCEAN BLVD FL 2
FORT LAUDERDALE FL
33308-6424
US

V. Phone/Fax

Practice location:
  • Phone: 954-835-5741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: