Healthcare Provider Details

I. General information

NPI: 1891561072
Provider Name (Legal Business Name): HANNAH RUGANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464099 FLORIDA 200 STE 2
YULEE FL
32097
US

IV. Provider business mailing address

300 INTERNATIONAL PARKWAY STE 200
LAKE MARY FL
32746
US

V. Phone/Fax

Practice location:
  • Phone: 904-875-4461
  • Fax:
Mailing address:
  • Phone: 866-610-0580
  • Fax: 866-611-1558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: