Healthcare Provider Details

I. General information

NPI: 1083540702
Provider Name (Legal Business Name): ANDREW RUGGIERO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 VIA ROSINA
JUPITER FL
33458-6932
US

IV. Provider business mailing address

166 VIA ROSINA
JUPITER FL
33458-6932
US

V. Phone/Fax

Practice location:
  • Phone: 561-676-0241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN31832
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: