Healthcare Provider Details

I. General information

NPI: 1790732360
Provider Name (Legal Business Name): RUFFOLO HOOPER & ASSOCIATES MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5751 HOOVER BLVD
TAMPA FL
33634-5340
US

IV. Provider business mailing address

5751 HOOVER BLVD
TAMPA FL
33634-5340
US

V. Phone/Fax

Practice location:
  • Phone: 813-886-8334
  • Fax:
Mailing address:
  • Phone: 813-886-8334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License Number
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License Number
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: KIM PALMA
Title or Position: ACCOUNT MANAGER
Credential:
Phone: 813-886-8334