Healthcare Provider Details

I. General information

NPI: 1710676697
Provider Name (Legal Business Name): JOSEPH STEPHEN RUGGIERO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-6413
  • Fax: 407-303-6414
Mailing address:
  • Phone: 407-303-6414
  • Fax: 407-303-6413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS23247
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: