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General NPI Number Information
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NPI Number | 1043293095
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Entity Type | Individual
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Provider Name | KIMBERLY ANN RUZEK MD
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Gender | Female
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 516 NOKOMIS AVE S
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City | VENICE
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State | FL
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Zip | 34285-2817
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Country | US
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Telephone | 941-488-7781
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 1508
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City | VENICE
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State | FL
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Zip | 34284-1508
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Country | US
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Telephone | 941-488-7781
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 90361
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 43033
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License Number State | MN
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