MEDICARE: MS. ERIKA RUTH-VON EHRENPREIS

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
1	2278H0200X	Home Health Certified Respiratory Therapist

General Provider Information

NPI Number	:	1417563628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIKA RUTH-VON EHRENPREIS

Provider Business Mailing Address
First Line	:	4200 DOBLINS ROAD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-3252
Country	:	US
Telephone Number	:	941-250-2594
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 DOBLINS ROAD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-3252
Country	:	US
Telephone Number	:	941-250-2594
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	09/22/2020

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