=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437084662
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEADOWS MEDICAL CARE P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2026
-----------------------------------------------------
Last Update Date | 06/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8745 LAKE STREET RD
-----------------------------------------------------
City | LE ROY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14482-9344
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-679-2366
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20451 SENECA MEADOWS PKWY
-----------------------------------------------------
City | GERMANTOWN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20876-7005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-515-7260
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GENERAL MANAGER
-----------------------------------------------------
Name | MR. JEFF RUIZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 661-312-3970
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------