Healthcare Provider Details

I. General information

NPI: 1215157136
Provider Name (Legal Business Name): RUBY SATPATHY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 12/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 PRUDENTIAL DR SUITE 1700B
JACKSONVILLE FL
32207-8334
US

IV. Provider business mailing address

PO BOX 43667
JACKSONVILLE FL
32203-3667
US

V. Phone/Fax

Practice location:
  • Phone: 904-398-0125
  • Fax: 904-398-1832
Mailing address:
  • Phone: 904-224-5189
  • Fax: 904-725-1622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number23933
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number36898
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME126231
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME126231
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberME126231
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: