Healthcare Provider Details

I. General information

NPI: 1528938487
Provider Name (Legal Business Name): RUTHMARY ESTABROOK RN MSN FNP-C ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 SANTA BARBARA BLVD
THE VILLAGES FL
32159-6827
US

IV. Provider business mailing address

5101 CLOVER MIST DR
APOLLO BEACH FL
33572-3417
US

V. Phone/Fax

Practice location:
  • Phone: 352-259-2159
  • Fax: 352-259-5731
Mailing address:
  • Phone: 813-776-1272
  • Fax: 656-222-6059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number11043682
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA188464
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11043862
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN227358
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberC-RXN.0103784-C-NP
License Number StateCO
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRNCNP88991
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: