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NPI Code Detail

MEDICARE: VANJA RUKAVINA

MEDICARE:   VANJA  RUKAVINA
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1265399562
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANJA RUKAVINA
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number : 772-349-6317
Fax Number :
Provider Business Practice Location Address
First Line : 646 MERRIOTT LN
Second Line :
City : WOODBURN
State : OR
Zip : 97071-6041
Country : US
Telephone Number : 971-226-0083
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2026
Last Update Date : 01/07/2026

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Directions to “ VANJA RUKAVINA ” Practice Location

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