MEDICARE: NAOMI RUEHLMAN LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1710385778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAOMI RUEHLMAN LLC

Provider Business Mailing Address
First Line	:	2226 NW PADOVA ST
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-4376
Country	:	US
Telephone Number	:	772-345-6812
Fax Number	:

Provider Business Practice Location Address
First Line	:	2226 NW PADOVA ST
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-4376
Country	:	US
Telephone Number	:	772-345-6812
Fax Number	:

Authorized Official
Title or Position	:	HOME HEALTH AIDE
Name	:	NAOMI RUEHLMAN
Credential	:
Telephone Number	:	772-345-6812

Provider Enumeration Date	:	12/08/2014
Last Update Date	:	12/08/2014

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