Healthcare Provider Details

I. General information

NPI: 1477902492
Provider Name (Legal Business Name): RUTH OCCEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 07/16/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 NEMOURS PKWY
ORLANDO FL
32827-7884
US

IV. Provider business mailing address

NEMOURS CHILDREN'S HOSPITAL 6535 NEMOURS PARKWAY
ORLANDO FL
32827
US

V. Phone/Fax

Practice location:
  • Phone: 407-567-4000
  • Fax:
Mailing address:
  • Phone: 407-507-7156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9406906
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9406906
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: