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General NPI Number Information
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NPI Number | 1326320565
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Entity Type | Individual
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Provider Name | ANDREW JOSEPH RUFFOLO RPH
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Gender | Male
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 4600 S WASHINGTON AVE
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City | TITUSVILLE
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State | FL
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Zip | 32780-7339
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Country | US
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Telephone | 321-269-7573
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Fax | 321-383-3149
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Provider Business Mailing Address
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Address Line | 2075 LEEWARD LN
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-3062
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Country | US
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Telephone | 321-302-2780
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS0020507
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License Number State | FL
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