Healthcare Provider Details

I. General information

NPI: 1285808634
Provider Name (Legal Business Name): MARIA C RUGAMAS CFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 09/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 W 9000 S SUITE 210
WEST JORDAN UT
84088-8876
US

IV. Provider business mailing address

3570 W 9000 S SUITE 210
WEST JORDAN UT
84088-8876
US

V. Phone/Fax

Practice location:
  • Phone: 801-569-5328
  • Fax: 801-569-5333
Mailing address:
  • Phone: 801-569-5328
  • Fax: 801-569-5333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: