Healthcare Provider Details

I. General information

NPI: 1831648492
Provider Name (Legal Business Name): MARIO RUEDA MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 09/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 BURNS RD
PALM BEACH GARDENS FL
33410-4349
US

IV. Provider business mailing address

3375 BURNS RD
PALM BEACH GARDENS FL
33410-4349
US

V. Phone/Fax

Practice location:
  • Phone: 561-799-9559
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIO RUEDA
Title or Position: SURGEON
Credential: MD
Phone: 561-799-9559