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NPI Code Detail

MEDICARE: RUTH M. KING PA-C

MEDICARE: RUTH M. KING PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA3060FL
2363A00000XPhysician AssistantPA3060FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3E4338UOTHERFLMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2Y04Z7OTHERFLBCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083725048
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUTH M. KING PA-C
Provider Business Mailing Address
First Line : 2675 WINKLER AVE FL 2
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9342
Country : US
Telephone Number : 877-856-3774
Fax Number :
Provider Business Practice Location Address
First Line : 1201 MONUMENT RD STE 200
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-7428
Country : US
Telephone Number : 904-727-5151
Fax Number : 904-727-3887
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 01/24/2022

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Directions to “ RUTH M. KING PA-C” Practice Location

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