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General NPI Number Information
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NPI Number | 1265612733
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Entity Type | Organization
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Legal Business Name | RIVERSIDE MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 09/21/2017
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Provider Practice Location Address
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Address Line | 5441 N UNIVERSITY DR SUITE 101
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4640
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Country | US
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Telephone | 954-753-3910
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Fax | 954-753-3857
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Provider Business Mailing Address
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Address Line | 5441 N UNIVERSITY DR SUITE 101
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4640
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Country | US
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Telephone | 954-753-3910
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Fax | 954-753-3857
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NICHOLAS J. RUGGIERO
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Credential | D.C.
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Telephone | 954-753-3910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH6165
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License Number State | FL
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