Healthcare Provider Details

I. General information

NPI: 1003306432
Provider Name (Legal Business Name): RUBY ANGELA GAGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 07/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 NE 8TH AVE
OAKLAND PARK FL
33334
US

IV. Provider business mailing address

8988 NW 38TH DR
CORAL SPRINGS FL
33065-4453
US

V. Phone/Fax

Practice location:
  • Phone: 954-547-7180
  • Fax:
Mailing address:
  • Phone: 754-368-7112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: