Healthcare Provider Details

I. General information

NPI: 1053613463
Provider Name (Legal Business Name): BEHRUZE RUYANI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 11/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N 35TH AVE SUITE 245
HOLLYWOOD FL
33021-5424
US

IV. Provider business mailing address

1150 N 35TH AVE SUITE 245
HOLLYWOOD FL
33021-5424
US

V. Phone/Fax

Practice location:
  • Phone: 954-987-5300
  • Fax: 954-987-5334
Mailing address:
  • Phone: 954-987-5300
  • Fax: 954-987-5334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: BEHRUZE RUYANI
Title or Position: PHYSICIAN
Credential: MD
Phone: 954-987-5300