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General NPI Number Information
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NPI Number | 1912912106
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Entity Type | Organization
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Legal Business Name | J D RUGGIERO MD PLLC
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 2035 PROFESSIONAL CENTER DR SUITE A
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City | ORANGE PARK
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State | FL
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Zip | 32073-4492
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Country | US
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Telephone | 904-272-3200
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Fax | 904-272-3211
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Provider Business Mailing Address
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Address Line | 2035 PROFESSIONAL CENTER DR STE A
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City | ORANGE PARK
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State | FL
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Zip | 32073-4462
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Country | US
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Telephone | 904-579-4692
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Fax | 904-639-6002
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH DAVID RUGGIERO
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Credential | MD
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Telephone | 904-834-1002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number |
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License Number State | FL
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