Healthcare Provider Details

I. General information

NPI: 1255907846
Provider Name (Legal Business Name): JANEVI JUNE RUIZ REBERNIGG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 WALDEMERE ST STE 512
SARASOTA FL
34239-2941
US

IV. Provider business mailing address

1921 WALDEMERE ST STE 512
SARASOTA FL
34239-2941
US

V. Phone/Fax

Practice location:
  • Phone: 941-917-3270
  • Fax: 941-917-3275
Mailing address:
  • Phone: 941-261-0772
  • Fax: 941-412-1911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number58.033891
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberOS23459
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: