Healthcare Provider Details

I. General information

NPI: 1821500158
Provider Name (Legal Business Name): CHRISTINE JOAN RUANE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 TERRA MANGO LOOP STE B
ORLANDO FL
32835-8507
US

IV. Provider business mailing address

125 TERRA MANGO LOOP STE B
ORLANDO FL
32835-8507
US

V. Phone/Fax

Practice location:
  • Phone: 407-214-7037
  • Fax: 407-337-5985
Mailing address:
  • Phone: 407-214-7037
  • Fax: 407-337-5985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH12338
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: