Healthcare Provider Details

I. General information

NPI: 1093769697
Provider Name (Legal Business Name): ERNESTO J RUAS, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 S BOULEVARD
TAMPA FL
33606-2629
US

IV. Provider business mailing address

603 S BOULEVARD
TAMPA FL
33606-2629
US

V. Phone/Fax

Practice location:
  • Phone: 813-259-1550
  • Fax: 813-258-1287
Mailing address:
  • Phone: 813-259-1550
  • Fax: 813-258-1287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ERNESTO J RUAS
Title or Position: OWNER
Credential: M.D.
Phone: 813-259-1550