Healthcare Provider Details

I. General information

NPI: 1447351531
Provider Name (Legal Business Name): RICHARD CHARLES RUCK II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4494 PALMER RD N WALTER REED NMMC
BETHESDA MD
20814
US

IV. Provider business mailing address

5331 SW 7TH AVENUE RD
OCALA FL
34471-7465
US

V. Phone/Fax

Practice location:
  • Phone: 571-423-9616
  • Fax:
Mailing address:
  • Phone: 571-423-9616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number162326
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number32895
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: